Surgical Options

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If you’re looking for more permanent birth control, there are two main options to consider.

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Vasectomy

A permanent surgical procedure to close or block the vas deferens (the tubes that carry sperm to the penis). Since it is permanent, this option is especially for those who have decided that their family is complete or that they don’t want to have children. Compared to female surgical birth control, the vasectomy is safer, more effective, less expensive, and less invasive.

How it works

  • In this procedure, the vas deferens is partially removed or blocked, so that no sperm is released to fertilize the egg
  • Using local anesthesia, a healthcare professional will reach the vas deferens either by making a small incision on the skin of the scrotum (conventional vasectomy) or by making a small puncture on the skin of the scrotum (no-scalpel vasectomy)
  • Another form of contraception is required until a semen analysis shows no sperm

Effectiveness

Although 98% effective, failures do occur and can happen many years after the procedure. 

Pros

  • Permanent
  • Simple procedure, no follow-up required (aside from sperm analysis)
  • Does not interfere with sex or affect sexual function
  • Discreet and cost-effective
  • Less invasive and fewer complications than female sterilization
  • No significant long-term side effects
  • Allows the male partner to assume some responsibility for contraception

Cons

  • Permanent and irreversible
  • Risk of having regrets later on
  • Not effective immediately – must use another contraception method for 3 months and do a follow-up sperm test to ensure no sperm are present in the semen
  • Possible short-term surgery-related complications may include pain, bleeding, vasovagal reaction, infection at the incision site, bruising and swelling of the scrotum
  • Rarely, the vas deferens could reconnect by themselves
  • Does not protect against sexually transmitted infections (STIs)

Tubal ligation or occlusion

Performed by a gynecologist, there are two main types of surgery for female sterilization – tubal ligation or tubal occlusion. Both are permanent surgical procedures.

How it works

  • In tubal ligation, the two fallopian tubes, which transport the eggs from the ovaries to the uterus, get disconnected. This is considered permanent, because reversal is costly, difficult, and not guaranteed
  • In tubal occlusion, a micro-insert is placed into each of the fallopian tubes. The micro-inserts work with your body to form a natural barrier that helps keep sperm from reaching the eggs, preventing pregnancy

How it's done

  • Tubal ligation can be performed via: 
  • Laparoscopy – using general anesthesia, a gynecologist will make small incisions over the abdomen and either clip, burn or remove the fallopian tubes
  • Abdominally – during a caesarean section, a gynecologist can access the fallopian tubes to either clip or remove them
  • Tubal occlusion may be performed via:
  • Hysteroscopy – using only local anesthesia, a gynecologist will put micro-inserts in your fallopian tubes through a vaginal approach. It takes 3 months for this method to be effective, at which time a confirmation test (e.g. x-ray, ultrasound) is done to make sure the tubes are fully blocked

 

Effectiveness

  • Although highly effective, failures do occur and can happen many years after the procedure. Failure rates vary depending on which technique is used
  • Be sure to review the latest data available with your healthcare provider before selecting the option that is most appropriate for your needs

Pros

  • Permanent
  • Simple procedure
  • Does not interfere with sex or affect sexual function 
  • Discreet and cost-effective
  • May help reduce the risk of ovarian cancer (specific to tubal ligation)
  • No incisions or scars (specific to tubal occlusion with micro-inserts)
  • Can be  performed in an outpatient setting (specific to tubal occlusion with micro-inserts)

Cons

  • Permanent and irreversible
  • Risk of having regrets later on
  • Not effective immediately when micro-inserts are used – must use another contraception method for 3 months and do a follow-up confirmation test (e.g. x-ray, ultrasound) that shows if tubes are fully blocked (specific to tubal occlusion with micro-inserts)
  • Possible short-term surgery-related complications may include pain, bleeding, infection at the incision site, trauma to adjacent organs in the abdomen
  • Possible procedure-related complications during and following the micro-inserts placement may include pain, cramping and vaginal bleeding (specific to tubal occlusion with micro-inserts)
  • Risk of ectopic pregnancy if failure occurs
  • Rarely, risk of not being able to put in the micro-inserts or of them slipping out (specific to tubal occlusion with micro-inserts)
  • Follow-up may be required (x-ray) (specific to tubal ligation)
  • Rarely, the fallopian tubes could reconnect by themselves (specific to tubal ligation)
  • Does not protect against sexually transmitting infections (STIs)

Disclaimer: The contents of this article are for informational purposes only and may not be complete, and are not intended, nor should they be used, as a substitute for professional medical advice. Always seek the advice of your physician or other qualified healthcare professional with any questions you may have regarding contraception.
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