Female Sterilization

Female sterilization is meant to be permanent and irreversible. This means that you should not have this done unless you are absolutely certain that you never wish to become pregnant again. The failure rate is approximately 1% in your lifetime. There are good alternatives for reversible contraception if you are not sure such as an intra-uterine contraceptive device (IUD).

There are three general surgical approaches to female sterilization:

Open abdominal surgery — in this procedure, a small incision is made in the abdominal wall either near the navel or near the pubic hair at other times. The fallopian tube is grasped and either cut, tied, or burnt. This is also the technique done at the same time as a cesarean section.

Laparoscopic surgery — this has largely replaced open tubal ligations except immediately after child birth or at the time of a cesarean section. A small incision is made in the umbilicus and an instrument is passed through this incision. The fallopian tubes are burnt, clipped, or placed within a tight ring. This destroys a portion of the tube. The most effective is to burn the tubes since it does the most damage. Unfortunately, this type of tubal ligation is the most difficult to reverse of you want another child in the future.

Hysteroscopic sterilization — Essure — this is a simple procedure which can be done in the office with light sedation. A plug is passed into the fallopian tube through the uterus. The only problem is that an x-ray of the uterus (hysterosalpingogram) needs to be done four months after the procedure to insure that the procedure has worked.