Female sterilization

Female sterilization procedures

In female sterilization, surgery is used to interrupt the pathway – the Fallopian tubes – along with the ova travel to reach the uterus. The Fallopian tubes are either cut and tied, removed, burnt, or blocked by clips or rings. The operation itself can be performed through the vagina or the abdomen. For vaginal sterilization the woman is given a local or general anaesthetic and an incision made in the vagina wall. The Fallopian tubes are gently pulled into the vagina, and their continuity can then be interrupted. The vaginal route is used by some surgeons because it does not leave a visible scar. It does, however lead to a somewhat greater number of post-operative infections than when the operation is conducted through the abdominal wall. It also needs more practice and skill on the part of the surgeon. An advantage is that in some hospitals the woman can go home the same day. The majority of female sterilizations are performed by laparoscopy. In this procedure, the patient is given a general or an epidural anaesthetic. The surgeon then makes one or two incisions into the abdomen. The cuts are usually very small, and the fine laparoscope*, and forceps, are inserted into the pelvic cavity. The surgeon locates the Fallopian tubes. These can then be pulled out through the incision or the operation can proceed inside the patient. This is usually achieved either by mounting a clip or a clamp of plastic or metal onto each Fallopian tube or by cauterizing each tube in one spot. Thus the tubes are blocked. Whichever method is used, it will always be followed by the formation of scar tissue – thus further occluding the tubes.

After a laparoscopy, the tiny incisions can be closed with one stitch, a clip, or even just tape. The incisions,

usually located in the navel and to one side of the abdomen, will heal within a few days and the scars normally fade and become unnoticeable within a year. The patient can leave hospital the same day although sometimes she is asked to stay overnight.

Apart from slight bruising, sterilization will have no painful after effects. Once the tiny wounds have healed, sexual activity can be resumed. There has been found to be no difference in sexual desire or pleasure – except possibly providing relief at having had the fear of pregnancy removed. Menstruation will continue as usual. In spite of the myths, sterilization does not cause a woman to put on weight or become less feminine. There may, however, be a slightly increased risk of an ectopic pregnancy. A tiny aperture that may have been left in the otherwise blocked tube, although not possible for an egg to pass through, may be large enough for a sperm. If the egg is fertilized, because its passage to the uterus is blocked, it will embed itself outside the uterus.