Hysteroscopic Sterilization

1 What is a Hysteroscopic Sterilization (Surgical Sterilization)?

Read on to learn more about a hysteroscopic sterilization (surgical sterilization).

A woman must use some method of birth control (contraception) if she is sexually active, fertile and physically able to become pregnant, and if she does not want to become pregnant but no method available today is considered to be 100% effective and offers perfect protection against sexually transmitted infections (sexually transmitted diseases, or STDs), except abstinence.

The permanent method of contraception is surgical sterilization. In certain cases, it can be reversed, but success cannot be guaranteed. It is meant only for men and women who do not intend to have children in the future. Surgical sterilization does not protect men or women or their partners from sexually transmitted infections.

A form of surgical sterilization for a man is vasectomy and ensures that no sperm will exit from his penis when he ejaculates during sexual intercourse. It is performed by a urologist or a general surgeon under local anesthesia.

During the procedure through two small opening in the scrotum, the tubes that carry sperm for the testicles into the urethra from each testicle (called the vas deferens or spermatic ducts) are severed and open ends are closed off.

After the procedure, the man can feel tenderness or bruise around the incision site. A vasectomy does not interfere with the ability of a man to have an erection, but after the procedure, the second form of birth control should be used until his ejaculate fluid is found to be free from sperm, usually after 10 to 20 ejaculations.

Tubal ligation is a form of surgical sterilization for women and ensures that an egg can no longer travel down the tube to the uterus and sperm cannot make contact with the egg. It should have no effect on a woman’s menstrual cycle or hormone production.

During surgery, under general, regional or local anesthesia, a surgeon or ob/gym using one of several procedures (laparoscopy or mini-laparotomy) access a woman's Fallopian tubes (which run from the top part of her uterus to each ovary) through small incision, closed off by using a clip, cutting and tying, or cauterizing (burning) the tubes.

The procedure takes anywhere from 10 to 45 minutes. Less than 2% of mostly younger woman can become pregnant after a tubal ligation. Also, it can be surgically reversed, usually with more success than in men who have had a vasectomy.

Side effects may include bleeding infection and the ones associated with being under general anesthesia.

During recent years, the subject of debate is a condition referred to as "post-tubal ligation syndrome" (or post-tubal sterilization syndrome). Some physicians think that the procedure damage the blood supply to the ovaries and menstrual irregularities and symptoms like as hot and mood changes can occur.

A study reported in New England Journal of Medicine in 2000 in over 9,500 women failed to confirm this kind of syndrome but still some investigators suggest this can be a problem in some women.

Hysteroscopic sterilization is a nonsurgical form of permanent birth control. During the procedure, a physician, under local anesthesia, inserts a 4-centimeter (1.6 inches) long metal coil into each one of a woman's two Fallopian tubes via a scope passed through the cervix into the uterus (hysteroscopy), and from there into the openings of the Fallopian tubes.

Over the next few months, tissue grows over the coil to form a plug that prevents fertilized eggs from traveling from the ovaries to the uterus. The procedure takes about 30 minutes.

Next, 3 months after the procedure, women must use other forms of birth control until their physician verifies by an imaging test called a hysterosalpingogram (HSG) that the Fallopian tubes are completely blocked. The advantage of hysteroscopic sterilization over tubal ligation is the use of local anesthesia and no incision.

A hysterectomy is the surgical removal of a woman's uterus and sometimes ovaries as well, depending on her overall health status and the reason for the operation, but contraception should be considered a secondary benefit and not a sole reason to have this procedure.

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