Abstract
The transcervical quinacrine pellet method developed by Zipper and co-workers is potentially a much needed safe, inexpensive, and effective non-surgical method of female sterilization. This method utilizes an intrauterine device inserter to deposit 250 mg of quinacrine hydrochloride as pellets in the uterine cavity. No complications or side effects, other than temporary pain and oligomenorrhea, have been reported.
Tetracycline has an established track record for safety. It also has been reported to have properties similar to quinacrine as a sclerosing agent, with potential as a non-surgical method using the quinacrine insertion technique.
To expand the experience with quinacrine and to study tetracyline as an alternative, studies were undertaken under the auspices of the Indian Rural Medical Association in Calcutta, India. During the period 14 August, 1979 to 28 June, 1984, 414 women received three insertions of 200 mg of quinacrine. There were 29 failures and a three-year life table failure rate of 8.5. During the period 25 April, 1984 to 28 December 1984, 55 women received three insertions of 200 mg of tetracycline. By 1 June, 1986 there were 32 failures among the 55 cases for a failure rate of 58%. A more recent study using a single dose of 1000 mg of tetracycline also produced unacceptably high failure rates.
Resumé
La méthode d'implantation transcervicale de pellets de quinacrine mise au point par Zipper et ses collaborateur est potentiellement une méthode non chirurgicale beaucoup plus sûre, meilleur marché et efficace de stérilisation féminine. Cette méthode utilise un dispositif d'insertion intra-utérine pour déposer, dans la cavité utérine, 250 mg de chlorhydrate de quinacrine sous forme de pellets. Aucune complication ou réaction secondaire n'a été signalée, si ce n'est des douleurs et une oligoménorrhée passagères.
Par ailleurs, la tétracycline présente une sécurite largement établie. On a également signalé qu'elle avait des propiétés similaires à celles de la quinacrine en tant qu'agent sclérosant et qu'elle pourrait être utilisée comme methode non chirurgicale en appliquant la technique d'insertion de la quinacrine.
Des études ont été entreprises sous l'égide de l'Association indienne de médecine rurale à Calcutta (Inde), dans le but d'elargir l'expérience acquise avec la quinacrine et d'étudier la tétracycline en tant que méthode de remplacement. Au cours de la période du 14 août au 28 juin 1984, 3 insertions de 200 mg de quinacrine ont été pratiquées sur 414 femmes. On a constaté 29 échecs et, d'après une table de survie portant sur 3 ans, un taux d'échec de 8.5%. Au cours de la période du 25 avril 1984 au 28 décembre 1984, 55 femmes ont reçu 3 insertions de 200 mg de tétracycline. Au 1 juillet 1986, il y avait eu 32 échecs parmi les 55 cas, soit un taux de 58%. Une étude plus récente basée sur une seule insertion de 1000 mg de tétracycline a également produit une proportion d'échecs d'une importance inacceptable.
Resumen
El método transcervical de comprimidos de quinacrina desarrollado por Zipper y colaboradores, es potencialmente un método no quirúrgico que hacía mucha falta, seguro, económico y efectivo para la esterilización femenina. Este método utiliza un insertador de dispositivos intrauterinos para depositar 250 mg de comprimidos de hidroclorato de quinacrina en la cavidad uterina. No se han denunciado otros efectos colaterales mas que dolor pasajero y oligomenorrea.
La tetraciclina tiene una trayectoria establecida con antecedentes de seguridad. También se sabe que posee propiedades similares a la quinacrina como agente esclerosante, con potencial para método no quirúrgico usando la técnica de inserción para la quinacrina.
Para aumentar la experiencia con quinacrina y estudiar la tetraciclina como alternativa, se hicieron estudios auspiciados por la “Indian Rural Medical Association” en Calcutta, India. Durante el periódo des de agosto 14, 1979, hasta junio 28, 1984, 414 mujeres recibieron 3 inserciones de 200 mg de quinacrina. Ocurrieron 29 fracasos y la tabla de vida a tres años dió una tasa de fracasos de 8.5. Durante el período de abril 25, 1984, a diciembre 28, 1984, 55 mujeres recibieron 3 inserciones de 200 mg de tetraciclina. Hasta julio 1, 1986, ocurrieron 32 fracasos entre los 55 casos, con una tasa de fracasos de 58%. Un estudio más reciente, usando una dosis única de 1000 mg de tetraciclina, también produjo tasas altas no aceptables de fracasos.
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Mullick, B., Mumford, S.D. & Kessel, E. Studies of quinacrine and of tetracycline for non-surgical female sterilization. Adv Contracept 3, 245–254 (1987). https://doi.org/10.1007/BF01849398
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DOI: https://doi.org/10.1007/BF01849398