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Vasectomies and Tubal Ligations

Sterilization Talk: Vasectomies and Tubal Ligations

Permanent birth control procedures for both men and women, what’s right for you?

Are you ready to stop having children permanently?

Many factors go into deciding whether or not a permanent form of birth control is desirable or necessary for you and your family versus the many temporary birth control options out there such as condoms, birth control pills, a intrauterine device (IUD), a diaphragm and/or others.

Some of the questions men and women might consider before becoming sterilized include:

  • Am I really ready to stop having children?
  • Am I financially able or willing to support another child if I get pregnant/impregnate my partner?
  • Will I/or my partner want another child in the future?
  • Should I get sterilized or should my partner do it?
  • Am I too old for another pregnancy? OR Am I too young for sterilization?
  • Is sterilization safe and effective?
  • Can I afford this type of surgery? Is it covered by insurance?
  • For women specifically: Do I have medical issues that might make pregnancy unsafe and therefore I should have my tubes tied?

If you’re in a relationship, you should have a talk with your partner to discuss what is best for the both of you. Whether you are in a relationship or not, it’s important to have an in-depth conversation with your healthcare provider who will help guide you in making your decision. Once you’ve decided, there are quite a few things you need to know.

For Women: Tubal Ligations

A tubal ligation is a surgical procedure most commonly referred to as, “having your tubes tied.” It involves cutting or blocking a woman’s fallopian tubes. The blockage is meant to prevent eggs from traveling from the uterus, through the tubes and finally to the ovaries where they’ll have a chance to be fertilized.

There are several methods of tubal ligation. It can be performed as:

  1. A surgery immediately following childbirth during which a small incision is made near the navel, the tubes are located and then sealed or cauterized. OR, if the patient has had a c-section, the surgery will be performed through the open cut.
  2. A same-day laparoscopic procedure (performed at a hospital or out-patient facility) where a tube with a camera lens at the end is inserted through two small incisions in the abdomen. This method is done within 30 minutes and leaves minimal scarring.
  3. As a non-surgical procedure during which the doctor will insert small springs into the fallopian tubes via the vagina. After a few months, the tubes will grow around the springs preventing sperm from being able to travel through them. This method is usually not effective until several months after the procedure so the patient will still have to use other methods of birth control for a little while.

Pain after the procedure is minimal and recovery time usually doesn’t take longer than two days. Afterwards, it safe to resume normal activity.

The reason tubal ligations are referred to as, “permanent birth control” is because, although pregnancy CAN occur after having one, it is extremely rare. Fewer than 5 out of 1000 women get pregnant after the first year and only 2 out of 100 get pregnant after the first ten years.

Although backup birth control is not needed afterwards, it is important to note that tubal ligations do NOT prevent against STDs so safe sex is still strongly advised if you are not in a monogamous relationship.

For Men: Vasectomies

A vasectomy is the male version of permanent birth control. In a vasectomy, the van deferens from each testicle is sealed, cut or clamped which prevents the sperm from mixing with the semen during ejaculation. If there is no sperm in the semen then the egg cannot be fertilized meaning pregnancy cannot occur.  The testicles will continue to produce sperm but, because the tubes are sealed and it now has nowhere to go, it is reabsorbed into the body.

In a traditional vasectomy, the surgeon will make one or two incisions into the cleaned and shaven scrotum, locate the vans deferens tubes and cut or seal them. Once the tubes are cut, the van deferens is pushed back into the scrotum and the incisions are closed with stitches. There is also a minimally invasive technique that is similar to the traditional except only one small hole is made and no stitches are required allowing for less discomfort, faster recovery and less complications.

After surgery, there will be slight pain and the scrotum will remain numb for 1-2hrs. Wear a jockstrap or fitted underwear to prevent initial discomfort. Recovery time is 1-2 days and then normal activity can resume. Sexual activity may take place after about a week but it can take several months before sperm is no longer present in the semen so initially condoms are required to prevent pregnancy. Only after a doctor deems that the sperm count is zero, is it safe to have sex without another form of birth control (however, note that vasectomies do not prevent STDs so safe sex is still necessary.)

Vasectomies are very effective and only 1-2 out of 1000 women are impregnated within the first year of their partner’s surgery. Having a vasectomy does not change a man’s sexual function or prevent normal ejaculation.

Complications

Complications after tubal ligations and vasectomies are extremely rare but some risks include: blood loss, damage to the bowel, bladder or major blood vessels, adverse reaction to anesthesia, sexual dysfunction, improper wound healing or infection, bruising and pelvic or abdominal pain. It is important to let your doctor know immediately if you experience any of these symptoms.

What if I change my mind afterwards?

Vasectomies and Tubal Ligations are procedures that were designed to be permanent; however, they are both reversible even though it is not recommended. Reversals are expensive and may not be effective depending on the amount of time that has passed since the original surgery.

Sterilization should be a thoughtful, careful and well researched decision made only after having a discussion with both your partner and your doctor. Once you’ve decided to go ahead with the procedure, both surgeries—vasectomies and tubal ligations—are safe and highly effective.