Sterilization

	Tweet

Introduction
In the United States, sterilization is the most popular method of birth control for couples who want no more children. Although sterilization is reversible in some instances, reversal surgery in both men and women is costly, complicated, and not always successful. Therefore, patients should be counseled carefully before sterilization and should view the procedure as final.

Vasectomy is a safe, simple procedure in which the vas deferens is severed and sealed through a scrotal incision under local anesthesia. Long-term follow-up studies on vasectomized men show no excess risk of cardiovascular disease. Several studies have shown a possible association with prostate cancer, but the evidence is weak and inconsistent.

Female sterilization procedures include laparoscopic bipolar electrocoagulation, or plastic ring application on the uterine tubes, or minilaparotomy with Pomeroy tubal resection. The advantages of laparoscopy are minimal postoperative pain, small incisions, and rapid recovery. The advantages of minilaparotomy are that it can be performed with standard surgical instruments under local or general anesthesia. However, there is more postoperative pain and a longer recovery period. The cumulative 10-year failure rate for all methods combined is 1.85%, varying from 0.75% for postpartum partial salpingectomy and laparoscopic unipolar coagulation to 3.65% for spring clips; this fact should be discussed with women preoperatively. Some studies have found an increased risk of menstrual irregularities as a long-term complication of tubal ligation, but findings in different studies have been inconsistent. A new method of transcervical sterilization, Essure, is approved by the FDA. The method involves the placement of an expanding microcoil of titanium into the proximal uterine tube under hysteroscopic guidance. The efficacy rate at 1 year is 99.8%.

When to Refer

Refer to experienced clinicians for Implanon or other subcutaneous insertion, IUD insertion, tubal occlusion or ligation, Vasectomy, or therapeutic abortion.

Abbott J. Transcervical sterilization. Best Pract Res Clin Obstet Gynaecol. 2005 Aug;19(5):743-56. [PMID: 16023892]

RELATED STORIES:
The risks and benefits of the combined oral contraceptive pill   Common breast problems   Adenomyosis: More common than you think   How is the Vaginal Opening Affected by Childbirth – And by Episiotomy?   Premenstrual Dysphoric Disorder   Pelvic Inflammatory Disease (PID; Salpingitis, Endometritis)   Vaginitis   Dysmenorrhea   Rape   Menopausal Syndrome   Contraception   Infertility   Painful Intercourse (Dyspareunia)   Persistent Anovulation (Polycystic Ovary Syndrome)   Ovarian Tumors

Comments

[ + Post Your Own ]

Now you're in the public comment zone. What follows is not Armenian Medical Network's stuff; it comes from other people and we don't vouch for it. A reminder: By using this Web site you agree to accept our Terms of Service. Click here to read the Rules of Engagement.

There are no comments for this entry yet. [ + Comment here + ]