Int. J. Gynaecol. Obstet., 1982, 20: 283-291 International Federation of Gynaecology & Obstetrics STERILIZATION IN BANGLADESH: MORTALITY, MORBIDITY, AND RISK FACTORS MICHAEL J. ROSENBERGa, ROGER W. ROCHATa, JALALUDDIN AKBARb, PATRICK GOULDa, ATIQUR R. KHANC, ANTHONY MEASHAMb and SURIYA JABEENa aCenters for Disease Control, Atlanta, Georgia, USA, bFord Foundation, Daeca, Bangladesh, =Planning Division, Government of Bangladesh, Dacca, Bangladesh and dDepartment of Obstetrics and Gynecology, Sir Salimullah Medical College, Dacca, Bangladesh (Received October 19th, 1981) (Accepted March 17th, 1982) Abstract Rosenberg MJ, Rochat R W , Akbar J, Gould P, Khan AR, Measham A, Jabeen S (Centers for Disease ,Control, Atlanta, GA, USA, Ford Foundation, Dacca, Bangladesh, Planning Division, Government of Bangladesh, Dacca, Bangladesh and Dept of Obstetrics and Gynecology, Sir Salimullah Medical College, Dacca, Bangladesh). Sterilization in Bangladesh: Mortality, morbidity, and risk fat tars. Int J Gynaecol Obstet 20: 283-291, 1982 Although surgical sterilization in Bangladesh is common and has been designated as the primary means of helping the country slow its population growth, no reliable information exists regarding the procedure’s safety. To define the types and rates of medical compli- cations associated with sterilization, we followed 5042 women and 264 men under- going sterilization. The problems that in- creased most markedly after the procedure compared with before included painful urination, shaking chills, fever for at least 2 days, and frequent urination. Most of the postoperative problems could be pre- dicted by the presence of the same problem before the operation. Factor analysis of complaints in those persons who did not Address all correspondence to: Michael J. Rosenberg, Center for Health F’romotion and Education, Centers for Disease Control, Atlanta, Georgia30333, USA. have a specific preoperative complaint showed that complaints clustered into three groups. urinary tract symptoms (urinary urgency and frequency ), skin problems (bleeding from the incision, sore with pus, and stitches or skin breaking open), and general complaints (weakness and dizziness). The patient’s sex, the sponsor and patient load of the steriliza- tion ten ter, and the dose of sedatives adminis- tered to women were significantly associated with specific postoperative complaints. Five women died during the study, resulting in a death-to-case rate of 9.9/10,000 procedures tubectomies; four deaths were due to respira- tory arrest caused by oversedation. Key words: Surgical sterilization; Painful urination; Shaking chills; Fever and frequent urination; Analysis of preoperative com- plaints; Contraception; Physical and labora- tory examinations; Pomeroy procedure; Vasectomies by ligating Introduction Surgical sterilization is now the most widely practiced method of contraception throughout the world [ 11. In Bangladesh, more than 170,000 sterilizations were per- formed from July 1979 to June 1980 [ 21, and a goal of 3.4 million sterilizations has been set for the next 5 years. Sterilization is expected to be the chief means of helping ItrtJ G.vnaecol Obstet 20