Contraception - Sterilisation and Vasectomy

Now for those considering this form of contraception, you're talking serious stuff. Although these methods are said to be reversible, it's still pretty radical. These forms of contraception are used mostly in those over the age of 35 years. This is usually because the couple is likely to have had children and are sure they don't want any more. For men and women the concept of these procedures basically have the same response. In both cases it prevents either the ovum (the female's egg) or the sperm from travelling to where fertilisation can take place. This is achieved by severing the route of either the egg or sperm permanently.

Sterilisation for women

There are several ways to prevent the movement of the egg from the ovaries through the passage of the fallopian tubes and into the uterus (it is in the uterus where conception of the egg can occur).
The procedure can be done either by anaesthetic or whist the woman is awake. This is dependent on the type of surgery chosen. The sterilisation occurs through either closing the fallopian tubes by:

• Vaginal total sterilisation. This procedure is performed under a general anaesthetic. The hospital stay is about 48 hours. The surgeon gains access to the fallopian tubes via the vagina. A portion of the fallopian tubes is removed and the remainder of the tubes are grasped together and tied with sutures. This prevents any access of an egg moving through the fallopian tubes and into the uterus.
  
  
• Postpartum sterilisation. This procedure is performed immediately after the birth of a child. Obviously the woman would have discussed this option well before the due date of the child, and would need to be adamant that she wanted sterilisation. This form of sterilisation is carried out easily and quickly due to the uterus being enlarged. A surgeon will place a small incision just below the navel, where he/she will remove a portion of the fallopian tube and the remaining section closed off with sutures.
  
  
• Minilaparotomy. This procedure is very similar to postpartum sterilisation. An incision is made just above the pubic area. The surgeon will use an instrument to elevate the uterus to gain access to the fallopian tubes, and just as postpartum sterilisation, a portion of the tubes is removed and the remaining section closed with sutures.
  
  
• Laparoscopic tubal sterilisation. This can be done through outpatient surgery (in and out in the one day). However a general anaesthetic is required. Sterilisation can be achieved through a laparoscopy being inserted into the abdomen just below the navel. A laparoscopy is a cylindrical instrument with a tiny light and lens attached. This allows the surgeon to view the reproductive organs. The fallopian tube are then either tied by using a small tight band, or by burning the midsection from each section of the cut fallopian tubes through another small (laparoscopic) incision.
  
  Many people think that the procedure of sterilisation is easily reversible. This however is a myth. Although a surgeon can attempt to reverse the procedure, it doesn't mean it will be a successful attempt. Therefore any couple considering this method of contraception should be prepared for the fact that they may be sterile for life.
  

Vasectomy

Vasectomies are similar to the procedure of sterilisation on women, however this form of sterilisation is performed on men. It has a 99% success rate efficiency. Unlike the sterilisation of women, this method is more easily reversible in men. For this method of contraception, although it can be reversible in some cases, the male must be sure he does not want any more children, as reopening the tubes can fail. Microsurgery is used in cases of this.

It is the tubes called the vas deferens that are severed, then either tied or sealed by burning. This procedure can be achieved through either a local or general anaesthetic. The vas deferens are accessed though a small incision on either side of the groin. It is regarded as minor surgery, however problems that can arise are bleeding or inflammation at the incision site. In some cases the procedure can fail, and the passages can reopen and pregnancy to a woman can result.

Sterilisation of both men and women are very serious forms of contraception. Couples must be extremely adamant about not wanting children in the future, and must consider that if they were to break up with their partner at some stage, would they want the procedure reversed? Although reversals of these procedures are being done more regularly, they are not always successful. So take some quality time with yourself and with your partner when you consider this option.


- Louise Ganey