Surgical contraception is seen as a permanent form of birth control and even though there are some methods of surgical sterilisation which are reversible, success is not always a guarantee.
Due to the fact that these surgical methods are considered to be permanent, such methods are meant for couples who are 100% certain that they do not want to have any more children.
The options are available to both men and women and include:
- Tubal ligation
- Hysteroscopic sterilisation
The vasectomy is a surgical procedure that has been created exclusively for men and the purpose of this process is to make certain that sperm does not exit from the penis when the man ejaculates during intercourse. Men who are concerned that this method of contraception will affect their ability to gain and maintain an erection, or that the procedure will in anyway interfere with their sex life are assured of the fact that a vasectomy is completely safe and will have no effect on the man’s libido or ability to ejaculate.
The vasectomy is performed by an urologist or a general surgeon and is done under local anaesthetic. During the procedure the vas deferens, which are the tubes that carry the sperm from the testicles into the urethra, or the spermatic ducts from each testicle are disconnected. The open ends are then closed off. This option is safe and is usually done in a day clinic and simply involves two small incisions in the scrotum. Once the vasectomy is complete, most men complain of a slight tenderness around the area and slight bruising may be noticeable.
It is important to bear in mind that once a vasectomy has been performed, birth control should still be used for a certain period of time, as it is possible for the ejaculated fluid to still contain sperm and a man is only considered safe after at least 10 to 20 ejaculations. The vasectomy failure rate is as low as .02% and this means that the success rate is well over 99%. With its high success rate and since it is virtually painless, this surgical contraceptive method is a popular permanent birth control choice among many couples.
The vasectomy can be reversed, however the process is costly and the results are not guaranteed.
A tubal ligation is often referred to as -having one’s tubes tied’ and even though it is considered as a permanent option, the tubal ligation can be reversed, but again success is not a given. The procedure is commonly performed under general anaesthetic and the gynaecologist will make use of several different methods to access the woman’s Fallopian tubes. The tubes run from each ovary to the top section of the uterus.
A laparoscopy is among the most popular choices for a tubal ligation and here a small cut is made just below the woman’s naval. A scope (or viewing device) is inserted through the small incision and the doctor is able to view the Fallopian tubes. With the Fallopian tubes in view, the doctor will utilise a specially designed clamp or clip to seal the tubes or a decision may be made to cut and tie the tubes, or even cauterize (burn) the tubes. Under general anaesthetic the procedure takes no longer than 45 minutes and once awake, the woman feels very little discomfort.
This surgical method will prevent an egg from travelling down the Fallopian tube and into the womb and as such, sperm will not be able to make contact with the egg for fertilisation.
This procedure is considered to be 98% effective; with only 2% of women falling pregnant after undergoing a tubal ligation. The tubal ligation will have no impact on the woman’s menstrual cycle or hormone production.
This form of sterilisation is considered to be a permanent option and is generally considered to be a non-surgical procedure since no incisions are made. However it is performed under local anaesthetic and will involve a doctor inserting a 4 centimetre long metal coil into the woman’s Fallopian tubes. This is done using a scope or viewing device which will pass through the woman’s cervix and into the uterus and finally into the Fallopian tubes. Once the coil is inserted, scar tissue will grow around the coil and form a protective plug or a barrier and this essentially blocks the tubes. The blockage prevents any eggs travelling from the ovaries into the uterus. For a period of three months after the hysteroscopic sterilisation, a woman will be advised to use alternative forms of birth control and the success of the procedure will be confirmed by sonar where the doctor will confirm that the Fallopian tubes are indeed blocked.
As in the case of a tubal ligation, this method of sterilisation is considered to be permanent and reversal is often unsuccessful. It is often selected as an alternative to surgical sterilisation where women have experienced adverse side effects to general anaesthetic. Many women, up to as many as 6% who have undergone the procedure do develop side effects, however these are commonly caused by the improper placement and insertion of the metal coils.
Implanon is surgical method where a minor incision is made just under the skin and a device is implanted that will prevent pregnancy. Implanon offers effective birth control for a period of three years and has a very low failure rate (less than 1%). Implanon contains progestin, a hormone used to prevent pregnancy, however because of the use of hormones in the implant, a number of women have experienced side effects such as weight gain, headaches and irregular menstrual bleeding. Implanon is reversible and the insertion of the device is basically pain free.
A hysterectomy is one of the most permanent of all surgical contraception options and unless the operation is a medical requirement, women are urged to carefully consider other surgical and non- surgical contraceptive methods. In most cases, a hysterectomy is not done to prevent pregnancy, but birth control is a side effect of the surgery.
A hysterectomy is the surgical removal of a woman’s uterus and in some cases, the ovaries may be removed as well. The hysterectomy is not typically seen as a birth control method and is commonly performed due to severe or life-threatening health problems, including menstrual bleeding that is excessive, uterine fibroids or growths.
There are two methods used when performing a hysterectomy, and these include the laparoscopic hysterectomy where the uterus is removed through tiny incisions made in the abdomen and instruments are then used to assist with the removal. This method is only used if there are no complications and if cancer is not suspected. Usually the ovaries are left unless a woman’s health is at risk. A partial hysterectomy is becoming more common and in this method, the cervix is spared but the upper part of the uterus is removed.
Since the entire uterus is removed, this surgery is permanent and irreversible and a woman will not be able to bear children! In cases where the ovaries have been removed, a woman will experience immediate menopause and side effects of menopause are, hot flashes, mood swings and vaginal dryness. Hormone replacement therapy is recommended for women who have had hysterectomies performed and where the ovaries have been removed. The recovery period for this operation varies from woman to woman and the norm is considered to be between two to eight weeks.