Sterilization

What is Sterilization?

Sterilization in women is a permanent form of birth control or contraception to prevent pregnancy. Sterilization works by blocking or sealing the fallopian tubes to prevent the eggs from reaching the sperm and getting fertilized. The fallopian tubes are usually blocked by applying rings, clips, or by tying, cutting and removing a small piece of the tube. One of the most common methods of sterilization in women is tubal ligation.

Things to Know About Sterilization

• Sterilization has been more than 99% effective in preventing pregnancy.
• Sterilization is very difficult to reverse, so you need to make an informed decision before proceeding.
• Use of contraception to prevent pregnancy will no longer be required once you have undergone sterilization; however, you will need to use some form of contraception until your next period or for 3 months after the operation.
• It does not affect the level of your hormones and you will continue to have periods.
• It does not protect against sexually transmitted infections (STIs), so you may need to continue using condoms to prevent STIs.
• There is a small risk of complications, as with any surgery.
• There is a rare chance of pregnancy if the fallopian tubes fuse back together.
• There is an increased risk of ectopic or tubal pregnancy if you get pregnant after the operation.

Preparation for Sterilization

Some of the steps involved in preparation for sterilization include:

• Counseling with your doctor is important to discuss the operation in detail and clarify any doubts or questions you may have.
• Discuss with your partner about your decision to undergo sterilization. 
• You will need to use contraception until the day of surgery and until your next period after surgery.
• Before surgery, you will have to undergo a pregnancy test to make sure you are not pregnant. 

Methods of Sterilization

Some of the methods of sterilization include:

• Laparoscopic sterilization: Laparoscopic tubal ligation involves:
  • Your surgeon inserts a laparoscope (a thin, flexible fiberoptic tube with a small camera and light attached at the end) through a small surgical cut under the umbilicus.
  • Another small surgical cut is made at the lower abdomen to apply rings or clips to block the fallopian tubes.
  • This procedure is usually performed under general anesthesia and you can go home the same day.
• Postpartum sterilization: In this method of sterilization the fallopian tubes are tied within the first few days of delivery as the uterus is still expanded at that time.
  • A small surgical cut of 2 to 3 cm is done under the umbilicus and the tubes can be tied, cut, or a portion removed.
  • The entire procedure takes about 10 to 20 minutes and is carried out under general or local anesthesia.
  • If you have a Caesarean section, your tubes may also be tied and cut during the same procedure.
• Vaginal tubal sterilization: This method involves:
  • Your surgeon makes a small surgical cut in the vagina to remove sections of both fallopian tubes. 
  • There is no risk of abdominal adhesions or scars.
  • The operation is usually performed under local anesthesia.
  • You can go home soon after surgery.
• Mini-laparotomy and bilateral tubal ligation: In this method of sterilization:
  • A surgical cut of 3 to 5 cm is made at the lower abdomen and a section of both fallopian tubes is removed as done in postpartum sterilization.
  • The procedure is performed under local or general anesthesia.
  • Usually, stitches are removed after five days.
  • The hospital stay may vary but is usually longer than a laparoscopic operation.

Postoperative Care and Instructions

Post procedure, you will be monitored for an hour to ensure you are recovering as expected and that there are no complications. Usually, most people are discharged the same day of the procedure, normally within 2 hours. Recovery normally takes between 2 to 5 days. A follow-up appointment will be scheduled a week after the procedure to monitor your progress. Other instructions include:

• If you have had a general anesthetic, do not drive any motor vehicle for at least 2 days post procedure.
• You may normally return to work 5 days after surgery.
• Avoid strenuous activities or heavy lifting for about a week.
• You may need to use sanitary napkins for slight vaginal bleeding.
• You may also experience some pain and medicine will be provided for your comfort
• If bleeding or pain gets worse, you should seek immediate medical care.

Risks and Complications of Sterilization

As with any surgery, there are certain risks associated with sterilization, such as:

• Bleeding
• Infection
• Pain
• Damage to adjacent organs
• Anesthetic complications
• Failure of the operation