This is an operation which effectively
ends the fertile period of your life. It is not a decision to be taken lightly and all other forms of contraception must be considered, including male sterilization as that is a much easier and safer procedure. The failure rate of a vasectomy (male sterilization) is 1 in 2,000.
Is the operation reversible?
The only reason to consider sterilization is that you never want to become pregnant again under any circumstances. Some women may later regret the decision and seek to have the operation reversed. Reversal is not available on the NHS and is very rarely successful.
The operation requires a general anesthetic and is usually performed with a “laparoscope”. This is a telescope-like instrument that is inserted into the abdomen, which is gently inflated so that the tubes can be seen. A second small hole is made and clips are usually applied to seal the tubes. If this fails, an open surgery may be performed. The operation can be performed at any time within the menstrual cycle. Following the operation, you should use contraception until you have a period.
Most women will go home the same day and it is normal to have some abdominal and shoulder achiness due to the inflation of the abdomen during the surgery, but this settles quickly.
There is a 2 in 1000 risk of damaging the bowel or bladder when inserting the laparoscope and, in the event of this happening, an open operation or a bigger cut may be necessary to repair the damage. This risk is higher and occurs more often in women who have had previous abdominal surgery or those who are overweight.
If there are complications, a longer hospital stay will be required to allow for your recovery.
Is the operation 100 per cent successful?
About one in 200 women who have been sterilized become pregnant. This can occur several years after the operation. The failure rate is higher if the operation is performed immediately at the end of a pregnancy.
If the operation fails, the resulting pregnancy may be in the tube. Please seek medical advice if you think you are pregnant, have any abdominal pain or any vaginal bleeding.
Sterilization reversal is not funded by NHS and success rates of reversal are very small.
Other options which can be considered are:
- Vasectomy: Failure rate is 1 in 2000, safer, quicker to perform.
- LARC: a) Progesterone implant is most effective and reversible contraception available. Failure rate is <1 in 1000 over 3 years. b) Mirena: Other very effective form of contraception. Failure rate < 1 in 100 over 5 years, and recommended management of heavy menstrual bleeding causing amenorrhea in significant number of cases
Will the operation alter my periods?
No. Many women feel the operation causes problem periods. This is NOT true. Clip sterilization does not alter periods. However, many women who have been on the “pill” as a contraceptive for many years find their periods unacceptable when they stop the pill after sterilization.
NOTE: This method of contraception does not protect against Sexually transmitted infections.
Pre Requisite for operation
It is important not to have unprotected sexual intercourse since the start of periods before the procedure. Pregnancy test will be done on day of procedure but it can not rule out very early pregnancy (called as Luteal phase pregnancy.
The small plasters on your abdomen can be removed the day after your operation. You may bath or shower but carefully dry the areas. Do not cover them over afterward.
Your stitches are generally dissolvable and thus you need not to worry about their removal. You may experience some slight vaginal bleeding. This should settle after a few days. Use sanitary pads, not tampons, until the bleeding stops. Once the general tiredness and discomfort wears off, you may return to work (usually in the next two to three days).
You have been advised of the following:
- You need to be accompanied home by an adult after your operation.
- It is advised to have somebody with you for 24 hours after your operation.
- Also to live within one hour’s drive of the hospital.
- You should not cook or operate kitchen appliances for 24 hours after your operation.
- You should not drive a car, ride a bike, operate heavy machinery, or make important legal or business decisions for 48 hours after your operation.