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Tests of Non-Surgical Contraception Appear Effective

November 06, 2000|SALLY SQUIRES | WASHINGTON POST

Women who want permanent--and foolproof--contraception now must turn to sterilization, which requires surgery, and sometimes general anesthesia, plus a few days of recovery. But an experimental technique could soon allow women to be sterilized without going under the knife, receiving general anesthesia or even being sidelined.

Called STOP (selective tubal occlusion procedure), the procedure is performed vaginally and requires no incision. Little or no local anesthesia is needed, and it can be performed in about 15 to 20 minutes.

Just like tubal ligation--the gold standard of sterilization--the procedure halts conception by preventing eggs from moving through the Fallopian tubes. But instead of cutting and tying the tubes, STOP promotes the growth of scar tissue that seals off the tubes.

It works like this: Doctors thread a hysteroscope through the vagina and up to the Fallopian tubes.

They then insert a flexible coil about 4 centimeters long and thinner than a pencil lead in each Fallopian tube. Made of soft, titanium-nickel alloy, the coil expands to fill the tube, prompting scar tissue to block the tube in about 12 weeks.

The procedure can cause some cramping, but "it is not much more complicated than placing an IUD in the uterus," says Susan Ballagh, assistant professor of obstetrics and gynecology at Eastern Virginia Medical School in Norfolk, one of the sites where STOP has been tested. Many women are comfortable enough during the procedure to watch the coils being inserted on a video monitor.

Preliminary studies of nearly 200 women, who have used STOP for an average of 11 months, show that the device promotes normal scarring, rather than development of abnormal tissue, Ballagh says.

Unlike other sterilization techniques that can sometimes be reversed, the procedure is permanent. For now, only women ages 21 to 40 who have already had at least one child are eligible for the procedure. They also must have a negative pregnancy test, regular menstrual cycles and no evidence of uterine fibroids or polyps.

Phase III clinical trials are the next step for STOP--the final hurdle before its manufacturer, Conceptus of San Carlos, Calif., can apply for Food and Drug Administration approval.

More information about the upcoming STOP trial, which will be conducted at eight medical centers, is available by calling (888) 963-7807 or at http://www.conceptus.com/trials.htm.

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