Sterilization, Women

Sterilization is a surgical procedure. This surgery permanently prevents pregnancy in women. This can be done by tying (with or without cutting) the fallopian tubes or burning the tubes closed (tubal ligation). Tubal ligation blocks the tubes and prevents the egg from being fertilized by the sperm. Sterilization can be done by removing the ovaries that produce the egg (castration) as well. Sterilization is considered safe with very rare complications. It does not affect menstrual periods, sexual desire, or performance.

Since sterilization is considered permanent, you should not do it until you are sure you do not want to have more children. You and your partner should fully agree to have the procedure. Your decision to have the procedure should not be made when you are in a stressful situation. This can include a loss of a pregnancy, illness or death of a spouse, or divorce. There are other means of preventing unwanted pregnancies that can be used until you are completely sure you want to be sterilized. Sterilization does not protect against sexually transmitted disease.

Women who had a sterilization procedure and want it reversed must know that it requires an expensive and major operation. The reversal may not be successful and has a high rate of tubal (ectopic) pregnancy that can be dangerous and require surgery.

There are several ways to perform a tubal sterlization:

  • Laparoscopy. The abdomen is filled with a gas to see the pelvic organs. Then, a tube with a light attached is inserted into the abdomen through 2 small incisions. The fallopian tubes are blocked with a ring, clip or electrocautery to burn closed the tubes. Then, the gas is released and the small incisions are closed.

  • Hysteroscopy. A tube with a light is inserted in the vagina, through the cervix and then into the uterus. A spring-like instrument is inserted into the opening of the fallopian tubes. The spring causes scaring and blocks the tubes. Other forms of contraception should be used for three months at which time an X-ray is done to be sure the tubes are blocked.

  • Minilaparotomy. This is done right after giving birth. A small incision is made under the belly button and the tubes are exposed. The tubes can then be burned, tied and/or cut.

  • Tubal ligation can be done during a Cesarean section.

  • Castration is a surgical procedure that removes both ovaries.

Tubal sterilization should be discussed with your caregiver to answer any concerns you or your partner might have. This meeting will help to decide for sure if the operation is safe for you and which procedure is the best one for you. You can change your mind and cancel the surgery at any time.

HOME CARE INSTRUCTIONS

  • Follow your caregivers instructions regarding diet, rest, work, social and sexual activities and follow up appointments.

  • Shoulder pain is common following a laparoscopy. The pain may be relieved by lying down flat.

  • Only take over-the-counter or prescription medicines for pain, discomfort or fever as directed by your caregiver.

  • You may use lozenges for throat discomfort.

  • Keep the incisions covered to prevent infection.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop a temperature of 102° F (38.9° C), or as your caregiver suggests.

  • You become dizzy or faint.

  • You start to feel sick to your stomach (nausea) or throw up (vomit).

  • You develop abdominal pain not relieved with over-the-counter medications.

  • You have redness and puffiness (swelling) of the cut (incision).

  • You see pus draining from the incision.

  • You miss a menstrual period.