Vasectomy and tubal ligation *
INTRODUCTION
The purpose of this brochure is to increase your awareness of surgical sterilization (vasectomy for men and tubal ligation for women). This is a very effective, permanent method of contraception and does not change a couple's sex life. The purpose of this brochure is to increase your awareness of surgical sterilization (vasectomy for men and tubal ligation for women). This is a very effective, permanent method of contraception and does not change a couple's sex life.
While reconstructive surgery is possible, a couple that is planning surgical sterilization should view this method of contraception as irreversible. Results of reversal are often disappointing. Therefore, any desire to have more children must be excluded. This decision should not be made in a time of crisis or stress (abortion, difficult delivery, divorce, etc.). This is why a discussion with a health care professional is critical to weigh the advantages and disadvantages of this method, as well as, discussing various alternative methods (please refer to brochures on other methods of contraception).
While reconstructive surgery is possible, a couple that is planning surgical sterilization should view this method of contraception as irreversible. Results of reversal are often disappointing. Therefore, any desire to have more children must be excluded. This decision should not be made in a time of crisis or stress (abortion, difficult delivery, divorce, etc.) This is why a discussion with a health care professional is critical to weigh the advantages and disadvantages of this method, as well as, discussing various alternative methods (please refer to brochures on other methods of contraception).
VASECTOMY
Description
A vasectomy is a minor surgical procedure that consists of permanently blocking the route taken by sperm by sectioning (cutting and sealing) the vas deferens (the tubes carrying sperm from the testes). This procedure is performed under local anesthetia and lasts about 10 to 15 minutes.
Effectiveness
Vasectomy is over 99% effective. However, sterility is not immediate. In addition, there is a possibility that the vas deferens will re-open during the healing period. Two negative sperm tests must, therefore, be obtained before sterility can be established. Tests are usually conducted at two and three months post-surgery. Most men are sterile after three months. If not, the tests are repeated until two consecutive negative sperm tests are obtained.
Contraindications
There are very few medical contraindications. The most significant contraindication is any uncertainty surrounding the desire to have more children.
Advantages
This minor surgery means that you don't have to worry about contraception any more. It does not alter your sex life (sensations) or your health. For all intents and purposes, the amount of ejaculate will remain the same, since sperm only makes up 2% of the volume. The rest of the semen (98%) comes from the seminal vesicles (glands located at the base of the penis) and the prostate.
Complications
After surgery, there may be bruising in the scrotum area, swelling or mild pain. Current studies do not show any relationship between vasectomies and prostate cancer.
Complications
After surgery, there may be bruising in the scrotum area, swelling or mild pain. Current studies do not show any relationship between vasectomies and prostate cancer.
Practical advice
Before your vasectomy, on the morning of surgery, wear tight underwear and shave the scrotum area (the sac containing the testes).
After the vasectomy:
•In the first 48 hours, place an ice bag on the area for 20 minutes every two to four hours to limit swelling and pain. Any bruising will disappear within seven to 10 days.
•If you experience pain, we recommend that you take acetaminophen (Atasol, Tylenol, etc.) and not aspirin, which will increase the risk of bleeding.
•Starting the next day, after removing the bandage, take lukewarm baths (10 to 15 minutes) twice a day, for one week.
•Avoid strenuous physical activity for one week after surgery.
•Sexual relations should not resume until one week after surgery.
•On the day of surgery, you will be given a pamphlet and two containers to provide sperm samples.
•Consider yourself as still fertile and use an effective method of contraception until the results are negative. If your partner's period is late, advise her to take a pregnancy test and, if needed, to see a doctor.
TUBAL LIGATION
Description
Tubal ligation (“tying the tubes”) is surgery that consists of preventing sperm from reaching the ovum (egg), and, as a result, preventing fertilization. The ovum, which is microscopic in size, will then disintegrate in the Fallopian tube and be eliminated naturally by the body. There are different methods for performing this surgery, the most common one being ligation by laparoscopy. This method greatly improves recovery and reduces surgical after-effects.
Effectiveness
Tubal ligation is 99.6% effective under ideal conditions. While extremely rare, pregnancy is always possible as a result of reversal (reconnection of the Fallopian tube). Ligation is effective immediately after surgery.
Methods used
Laparoscopy (most commonly used):
Two small incisions are made, one at the navel and one above the pubis. The physician will insert the end of the instrument (laparoscope) into one of these incisions to see the Fallopian tubes. A clip is inserted through the other incision, which is used to section or close the Fallopian tubes. This is usually day surgery. Recovery will take seven to 10 days.
Mini-laparotomy (rarely used):
A 2 – 10 cm incision is made on the stomach just above the pubis. You may be hospitalized for a few hours or up to two days. Recovery will take about two weeks.
Anesthesia
A general anesthetic is usually employed, but tubal ligation may also be performed under epidural anesthesia (injection into the spinal column). Some hospitals will even offer to perform tubal ligation under local anesthetic. You should discuss, with the surgeon, which method would be best for you.
Practical advice
Before tubal ligation: You will need to undergo preoperative examinations based on your state of health and type of surgery. You will need to fast for 6 to 8 hours before the procedure. You must also avoid wearing jewellery, make-up or nail polish.
After tubal ligation:Based on what the physician says, you will need to rest for a few days up to a few weeks. Ask the surgeon whether the stitches will dissolve or need to be removed. The surgeon will make recommendations about when you may start having sex. Menstrual periods usually are not affected by the surgery.
In the week after surgery, you may experience:
•Light pink bleeding at the surgical site
•Some abdominal swelling
•Mild vaginal bleeding due to the uterus having been moved during surgery
•A sore throat and hoarse voice (if you underwent general anesthetic)
•Mild shoulder pain
NOTE
•If you suspect you are pregnant (very rare), you must speak to a physician as soon as possible. If you become pregnant after a tubal ligation, there is an increased risk that the pregnancy could be located in a Fallopian tube (ectopic pregnancy).
•Tubal ligation and vasectomy are very effective methods for preventing pregnancy, but they do not protect against STDs.