A B C D E F G H I J K L M N O P R S T U V W

STERILIZATION (MALE AND FEMALE)

What is Sterilization (Male and Female) ?

Sterilisation is a permanent method of contraception for those who are sure they never want children or do not want more children. There is an operation to reverse sterilisation, but it is complicated, expensive and may not work. Many health authorities will not pay for reversal on the NHS. You should receive full information and counselling if you want to be sterilised. This gives you a chance to talk about any doubts, worries or questions you might have with the doctor.

How does Sterilization (Male and Female) work ?

Sterilisation works by stopping the egg and the sperm meeting. This is done by blocking the fallopian tubes (which carry an egg from the ovary to the womb) in women, or the vas deferens (the tube that carries the sperm from the testicles to the penis) in men.

How effective is it ?

There is a very slight risk that the operation will not work. The tubes that carry the sperm in men and the eggs in women can rejoin after sterilisation. The failure rate for male sterilisation (vasectomy) is about 1 in 2,000, once a vasectomy is presumed to have worked. This is after two clear semen tests (where no sperm are seen). The failure rate for female sterilisation is about 1 in 200 depending on the method used. Both vasectomy and female sterilisation can fail immediately or some years after the operation has been carried out. So if the woman ever thinks she might be pregnant, she should have a pregnancy test.

What are the advantages of Sterilization (Male and Female) ?

It does not interfere with sex and is a permanent method of contraception. Male sterilisation is a simple operation and takes about 10-15 minutes. It is more effective than female sterilisation.

What are the disadvantages?

After a vasectomy it usually takes a few months for all the sperm to disappear from your semen. You need to use another method of contraception until you have had two sperm (semen) tests which show that you have no sperm. Rarely the tubes rejoin (for both male and female sterilisation) and make you fertile again. Female sterilisation involves a small operation and usually a general anaesthetic. Sterilisation cannot be easily reversed. It does not protect you against sexually transmitted infections.

What does the operation involve?

Male sterilisation (vasectomy) - You will be given a local anaesthetic. The doctor will make a small cut(s) in the skin of your scrotum, to reach the tubes (vas deferens). The doctor will remove a small piece of each tube, or cut the tubes and close the ends. The cuts in your scrotum will be very small and you may not need to have any stitches. If you do, dissolvable stitches or surgical tape will be used. The operation takes about 10-15 minutes and may be done in a clinic, hospital outpatient department or doctor's surgery. - Female sterilisation - The fallopian tubes are blocked by: tying (ligation); removing a small piece of the tube (excision); sealing (cauterisation) or applying clips or rings. The operation can be done in several ways. Laparoscopy is the most common method of female sterilisation. You will be given a general anaesthetic, or possibly a local anaesthetic. A doctor will make two tiny cuts, one just below your navel and the other just above the bikini line. They will then insert a laparoscope which lets the doctor clearly see your reproductive organs. The doctor will seal or block your fallopian tubes, usually with clips or rings. The other method of sterilisation is a mini-laparotomy. You will usually have a general anaesthetic and spend a couple of days in hospital. The doctor will make a small cut in your abdomen, usually just below the bikini line, to reach your fallopian tubes. The time you stay in hospital after sterilisation depends on the anaesthetic and the method used. It can be as little as one day. To avoid pregnancy you must use contraception right up to the time you are sterilised and until you have your first period after the sterilisation.

What to look out for after the operation?

Male sterilisation - Your scrotum may become bruised, swollen and painful. You can help this by wearing tight-fitting underpants to support your scrotum day and night for a week. You should avoid strenuous exercise for at least a week. Occasionally, some men have bleeding, a large swelling, or an infection. In this case, see your doctor as soon as possible. Sometimes sperm may leak out of the tube and collect in the surrounding tissue (sperm granulomas). This may cause inflammation and pain immediately or a few weeks or months later. If this happens it can be treated. You can have sex as soon as it is comfortable. However at first, you will need to use an extra method of contraception because sperm are left in the tubes that lead to the penis. The rate these sperm are used up varies from man to man. After eight to twelve weeks you will have two semen tests two to four weeks apart to see if the sperm have gone. You can only rely on a vasectomy for contraception after you have had two clear semen tests (no sperm are seen). Your feelings, sex drive, ability to have an erection and climax won't be affected. The only difference will be that there will not be any sperm in the semen. Sperm are still produced but are absorbed by the body. The appearance and amount of the semen and the feelings of climaxing should be the same as before.

Female sterilisation - If you have a general anaesthetic you may feel unwell and a little uncomfortable for a few days. This is quite usual, and you may have to take things easy for a week or so. You may have some slight bleeding and pain. If this gets worse, see your doctor. Your ovaries, womb and cervix are left in place so you will still release an egg each month, but it is absorbed naturally by the body. Your sex drive and enjoyment of sex should not be affected. For many women it is improved, as they no longer fear an unplanned pregnancy. Occasionally some women find that their periods are heavier, but this is usually because of their age or stopping the combined pill, which may have lightened their periods. You can have sex as soon as it is comfortable to do so after the operation but you will need to use contraception until your first period after the operation. If you become pregnant after sterilisation, there is a small risk of the pregnancy developing outside your womb, usually in the fallopian tube. This is called an ectopic pregnancy. Although ectopic pregnancies are rare, they are serious. You should see your doctor straightaway if you think you might be pregnant or have a light or delayed period or if you have sudden or unusual pain in your lower abdomen.