McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
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What is female sterilization?

Female sterilization is a form of birth control in which a woman's fallopian tubes are surgically closed. Normally, the fallopian tubes carry the eggs to the uterus. Closing the tubes with surgery prevents pregnancy because it prevents sperm from reaching and fertilizing an egg.

It is important to realize that sterilization is usually permanent and may not be reversed through a second operation. However, if the fallopian tubes are clamped or tied, a woman may possibly become fertile again through the use of microsurgery.

A woman also becomes sterile if her uterus is removed (a hysterectomy). A woman cannot become fertile again after a hysterectomy.

When is it used?

Doctors generally recommend sterilization only in the following situations:

• A couple has had as many children as they want.
• Your life may be endangered by pregnancy.
• There is a high risk of passing on a serious hereditary disease.
• You are unable to use other birth control methods.

In the U.S. nearly one in every four married women between the ages of 15 and 44 chooses sterilization as a means of birth control.

How do I prepare for sterilization?

The doctor examines you and asks about your medical history, especially any problems relating to your reproductive system. The doctor may also ask you some questions to find out whether you are sure you want permanent sterilization.

Be sure to tell the doctor if you've ever had an allergic reaction to an anesthetic.

What happens during sterilization?

Laparoscopy and minilaparotomy are the procedures most often used to seal the tubes. These surgeries are performed in a clinic, a doctor's office, or an ambulatory surgical center. Most patients can go home the same day.

Before the surgery begins you are given a regional or general anesthetic. A regional anesthetic numbs part of your body, preventing you from feeling pain while you remain awake. A general anesthetic relaxes your muscles, puts you to sleep, and also prevents you from feeling pain.

For a laparoscopy, the doctor makes one or two small cuts in the abdomen. One is made just below the navel and the other in the pubic hair area. The doctor inserts an instrument called a laparoscope through one of the cuts. Using the laparoscope to see inside the abdomen, the doctor inserts an operating instrument through the other small incision to cut, tie, burn, or clamp the fallopian tubes.

A minilaparotomy is most often done after delivery of a baby because the position of the uterus makes it easy for the doctor to reach the fallopian tubes. A minilaparotomy requires only one incision. The incision must be large enough for the surgeon to see inside the abdomen and to put an instrument through to cut, tie, clamp, or burn the fallopian tubes.

A hysterectomy is an operation to remove all or part of the uterus. Sometimes the ovaries and fallopian tubes are also removed; this is called an oophorectomy. Doctors do not recommend a hysterectomy unless there are reasons other than sterilization for having it.

What happens after the surgical closing of the tubes?

You may feel some pain or discomfort for 24 to 48 hours after a laparoscopy or minilaparotomy. The doctor may suggest that you rest in bed for 24 to 48 hours and take acetaminophen for pain.

The doctor will want to see you again to be sure that you are healing properly.

If you were using birth control pills before the sterilization, you may notice menstrual changes after the procedure. These menstrual changes are not caused by the surgery. They occur because you are no longer taking the birth control pills.

What are the benefits of this procedure?

Sealing of the fallopian tubes almost always results in permanent sterilization and is a very reliable form of birth control.

What are the risks associated with this procedure?

Complications after sterilization are rare.

• There are some risks when you have general anesthesia. Discuss these risks with your doctor.
• A regional anesthetic may not numb the area quite enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia. In most cases regional anesthesia is considered safer than general anesthesia.
• You may develop an infection or bleeding.
• Scar tissue (adhesions) may form.
• In some cases, an ectopic pregnancy (pregnancy outside the uterus) may occur, particularly if the fallopian tubes were burned.

This procedure has a failure rate of 0.4%.

When should I call the doctor?

Call the doctor immediately if:

• You develop a fever.
• You have bleeding or discharge from the vagina.
• You are bleeding around the surgical site.
• You notice a green or yellow discharge from the surgical site.
• You develop redness or tenderness around the surgical site.

Call the doctor during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.