tubal ligation procedure

Tubal Ligation

Tubal ligation

Tubal ligation (or "tying the tubes") is surgery to close a woman's fallopian tubes. These tubes connect the ovaries to the uterus. A woman who has this surgery can no longer get pregnant (sterile).

Description

Tubal ligation is done in a hospital or outpatient clinic.

• You may receive general anesthesia. You will be asleep and unable to feel pain.
• Or, you may have local anesthesia (awake and unable to feel pain) or spinal anesthesia (awake but unable to feel pain). You will likely also receive medicine to make you sleepy.

The procedure takes about 30 minutes.

• Your surgeon will make one or two small surgical cuts in your belly, usually around the belly button. Gas may be pumped into your belly to expand it. This helps your surgeon see your uterus and fallopian tubes.
• Your surgeon will insert a a narrow tube with a tiny camera on the end (laparoscope) into your belly. Instruments to block off your tubes will be inserted through the laparoscope or through a separate, very small cut.
• The tubes are either burned shut (cauterized) or clamped off with a small clip or ring (band).

Tubal ligation can also be done right after you have a baby through a small cut in the navel or during a cesarean section.

Another sterilization method involves going through the cervix and placing coils or plugs in the tubes where they connect with the uterus (hysteroscopic tubal occlusion procedure). This technique does not involve cuts in the abdomen.

Advantages

• Permanent birth control.
• Immediately effective.
• Allows sexual spontaneity.
• Requires no daily attention.
• Not messy.
• Cost-effective in the long run.

Disadvantages

• Does not protect against sexually transmitted infections, including HIV/AIDS.
• Requires surgery.
• Has risks associated with surgery.
• More complicated than male sterilization.
• May not be reversible.
• Possible regret.
• Possibililty of Post Tubal Ligation Syndrome.

Will this surgery affect my libido?

No. The procedure has no effect on your sex drive or your hormone production. You’ll still ovulate each month, only the egg will never reach your uterus (it’s reabsorbed by your body). You’ll also continue to have menstrual periods.

Why the procedure is performed?

Tubal ligation may be recommended for adult women who know for sure they do not want to get pregnant in the future.

Even though many women choose to have tubal ligation, some are sorry later that they did. The younger the woman is, the more likely she will regret having her tubes tied as she gets older.

Tubal ligation is considered a permanent form of birth control. It is NOT recommended as a short-term method or one that can be reversed. Even so, major surgery can sometimes reverse it. About 50 to 80 women out of 100 who have their tubal ligation reversed are able to become pregnant. A hysteroscopic tubal occlusion procedure is very hard to reverse.

Risks

Risks for any surgery are:

• Bleeding
• Damage to other organs (bowel or urinary systems) needing more surgery for repair
• Infection

Risks for any anesthesia are:

• Allergic reactions to medicines
• Breathing problems or pneumonia
• Heart problems

Risks for tubal ligation are:

• Incomplete closing of the tubes, which could make pregnancy still possible. About 1 out of 200 women who have had tubal ligation get pregnant later.
• Increased risk of a tubal (ectopic) pregnancy if pregnancy occurs after a tubal ligation
• Injury to nearby organs or tissues from surgical instruments

Before the procedure:

Always tell your doctor or nurse:

• If you are or could be pregnant
• What drugs you are taking, even drugs, herbs, or supplements you bought without a prescription

During the days before your surgery:

• You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), and any other drugs that make it hard for your blood to clot.
• Ask your doctor which drugs you should still take on the day of your surgery.
• If you smoke, try to stop. Ask your doctor or nurse for help quitting.
• If you are having the tubal occlusion procedure, you will be asked to take a hormone for at least 2 weeks before the procedure.

On the day of your surgery:

• You will usually be asked not to drink or eat anything after midnight the night before your surgery, or 8 hours before the time of your surgery.
• Take the drugs your doctor told you to take with a small sip of water.
• Your doctor or nurse will tell you when to arrive at the hospital or clinic.

After the procedure:

·        You will probably go home the same day you have the procedure. Some women may need to stay in the hospital overnight.

·        You will have some tenderness and pain. Your doctor will give you a prescription for pain medicine or tell you what over-the-counter pain medicine you can take.

·        After laparoscopy, many women will have shoulder pain for a few days. This is caused by the gas used in the abdomen to help the surgeon see better during the procedure. You can relieve the gas by lying down.

·        You should avoid heavy lifting for 3 weeks, but you can return to most normal activities within a few days.

·        If you have the hysteroscopic tubal occlusion procedure, you will need to keep using a birth control method until you have a test 3 months after the procedure to make sure it worked.

Vasectomy procedure

Vasectomy

Vasectomy, what is vasectomy? A vasectomy is a surgical procedure for male sterilization and/or permanent birth control.

          During a vasectomy, the vas deferens (tube) from each testicle is clamped, cut, or otherwise sealed. This prevents sperm from mixing with the semen that is ejaculated from the penis. An egg can’t be fertilized if there is no sperm in the semen. The testicles continue to produce sperm, but the sperm are reabsorbed by the body. (This also happens to sperm that are not ejaculated after a while, regardless of whether you have had a vasectomy.) Because the tubes are blocked before the seminal vesicles and prostate, you still ejaculate about the same amount of fluid.

It usually takes several months after a vasectomy for all remaining sperm to be ejaculated or reabsorbed. You must use another method of birth control until you have a semen sample tested and it shows a zero sperm count. Otherwise, you can still get your partner pregnant.

During a vasectomy:

• Your testicles and scrotum are cleaned with an antiseptic and possibly shaved.
• You may be given an oral or intravenous (IV) medicine to reduce anxiety and make you sleepy. If you do take this medicine, you may not remember much about the procedure.
• Each vas deferens is located by touch.
• A local anesthetic is injected into the area.
• Your doctor makes one or two small openings in your scrotum. Through an opening, the two vas deferens tubes are cut. The two ends of the vas deferens are tied, stitched, or sealed. Electrocautery may be used to seal the ends with heat. Scar tissue from the surgery helps block the tubes.
• The vas deferens is then replaced inside the scrotum and the skin is closed with stitches that dissolve and do not have to be removed.

The procedure takes about 20-30 minutes and can be done in an office or clinic.

Types of Vasectomy:

• ·         No-scalpel vasectomy is a technique that uses a small clamp with pointed ends. Instead of using a scalpel to cut the skin, the clamp is poked through the skin of the scrotum and then opened. The benefits of this procedure include less bleeding, a smaller hole in the skin, and fewer complications. No-scalpel vasectomy is as effective as traditional vasectomy.

• ·         Vasclip implant procedure, the vas deferens is locked closed with a device called a Vasclip. The vas deferens(tube) is not cut, sutured, or sealed by burning, which possibly reduces the potential for pain and complications. Some studies show that clipping is not as effective as other methods of sealing off the vas deferens.

After the surgery:

• ·         Your scrotum will be numb for 1 to 2 hours after a vasectomy. Apply cold packs to the area and lie on your back as much as possible for the rest of the day. Wearing snug underwear or a jockstrap will help ease discomfort and protect the area.

•        You may have some swelling and minor pain in your scrotum for several days after the surgery. Unless your work is strenuous, you will be able to return to work in 1 or 2 days. Avoid heavy lifting for a week.

•          You can resume sexual intercourse as soon as you are comfortable, usually in about a week. But you can still get your partner pregnant until your sperm count is zero. You must use another method of birth control until you have a follow-up sperm count test 2 months after the vasectomy (or after 10 to 20 ejaculations over a shorter period of time). Once your sperm count is zero, no other birth control method is necessary.

•      Most men go back to the doctor's office to have their sperm count checked. But there is also a home test available.

•         A vasectomy will not interfere with your sex drive, ability to have erections, sensation of orgasm, or ability to ejaculate. You may have occasional mild aching in your testicles during sexual arousal for a few months after the surgery.

Why It Is Done

• ·         A vasectomy is a permanent method of birth control. Only consider this method when you are sure that you do not want to have a child in the future.

How Well It Works

• ·         Vasectomy is a very effective (99.85%) birth control method. Only 1 to 2 women out of 1,000 will have an unplanned pregnancy in the first year after their partners have had a vasectomy.

Risk of failure

Pregnancy may occur after vasectomy because of:

• Failure to use another birth control method until the sperm count is confirmed to be zero. It usually takes 10 to 20 ejaculations to completely clear sperm from the semen.
• Spontaneous reconnection of a vas deferens or an opening in one end that allows sperm to mix with the semen again. This is very rare.

Risks

The risk of complications after a vasectomy is very low. Complications may include:

• Bleeding under the skin, which may cause swelling or bruising.
• Infection at the site of the incision. In rare instances, an infection develops inside the scrotum.
• Sperm leaking from a vas deferens into the tissue around it and forming a small lump (sperm granuloma). This condition is usually not painful, and it can be treated with rest and pain medication. Occasionally, surgery may be needed to remove the granuloma.
• Inflammation of the tubes that move sperm from the testicles (congestive epididymitis).
• In rare cases, the vas deferens grows back together (recanalization), and the man becomes fertile again.

Advantages

• Vasectomy is a permanent method of birth control. Once your semen does not contain sperm, you do not need to worry about using other birth control methods.

• Vasectomy is a safer, cheaper procedure that causes fewer complications than tubal ligation in women.

• Although vasectomy is expensive, it is a one-time cost and is often covered by medical insurance. The cost of other methods, such as birth control pills or condoms and spermicide, is likely to be greater over time.

Disadvantages

• A vasectomy does not protect against sexually transmitted diseases (STDs), including infection with the human immunodeficiency virus (HIV). Condoms are the most effective method for preventing STDs. To protect yourself and your partner from STDs, use a condom every time you have sex.