Birth Control Overview (cont.)
IN THIS ARTICLE
What is the effectiveness, and what are the side effects and risks of permanent methods of birth control?
Sterilization is considered a permanent form of birth control that a man or woman elects to undergo. Although tubal sterilization, or a tubal ligation, for women and vasectomy for men are sometimes reversible, reversal surgery is much more complicated than the original procedure and is frequently unsuccessful. Thus, when choosing a sterilization method you should not have thoughts of future reversal.
Hysterectomy or tubal ligation
Each year approximately one million American women elect to have surgery to occlude their Fallopian tubes (i.e. tubal ligation). Some women have a hysterectomy (removal of the uterus and sometimes the ovaries) each year, but usually primarily for birth sterilization to prevent pregnancy.
Most US women who have undergone sterilization by tubal ligation will have either a postpartum mini-laparotomy procedure or an interval (timing of the procedure does not coincide with a recent pregnancy) procedure. A postpartum tubal ligation is performed through a small incision in the lower crease of the navel right immediately following vaginal childbirth. If a Cesarean section is done, the tubal ligation is performed through the same abdominal incision. An interval tubal sterilization is usually performed using laparoscopy with instruments being introduced through small incisions made in the patient's abdominal wall (laparoscopic tubal ligation).
The Fallopian tubes (through which the egg passes after release from the ovary and where fertilization of the egg normally occurs) may be blocked with clips, bands, segmental destruction with electrocoagulation, or suture ligation with partial removal of the fallopian tube (i.e. partial salpingectomy). Female sterilization prevents fertilization by interrupting the passage through fallopian tube.
Fallopian tube implants (Essure)
The FDA has approved a small metallic implant (Essure) that is placed into the fallopian tubes of women who wish to be permanently sterilized. During the implantation procedure, the doctor inserts 1 of the devices into each of the 2 fallopian tubes. This is done with a special instrument called a hysteroscope that is inserted through the vagina and cervix into the uterus. The device works by inducing scar tissue formation over the implants, blocking the fallopian tubes and preventing fertilization of the egg by sperm.
Vasectomy (male sterilization)
Vasectomy involves an incision made in the scrotal sac, followed by cutting or burning of the vas deferens (tubes that carry sperm), and blocking both cut ends. The procedure is usually performed with the patient under local anesthesia in an outpatient setting. Vasectomy prevents the passage of sperm into seminal fluid by blocking the vas deferens. Some men may develop bruising in their testicles. After the vasectomy, some sperm may remain in the ducts. A man is not considered sterile until he has produced sperm-free ejaculations. Semen is tested in the lab several weeks after the procedure to insure that sperm are no longer present. This usually requires 15-20 ejaculations (the couple should use another form of birth control during this period, or the man may ejaculate by masturbation).
Medically Reviewed by a Doctor on 8/26/2016
Wayne Blocker, MD
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