Pearl obstetrics | gynaecology


Female sterilisation

  • sterilisation
    Laparoscopic female sterilisation using clips
    This is the simplest method of laparoscopic sterilisation. Alternatively both tubes can be completely removed.

Female sterilisation – Glengarry Private Hospital

Types of different sterilisation operations

There are several different types of female sterilisation operations that we can perform at Glengarry Private Hospital, Perth.

1. Laparoscopic sterilisation

Easily the most popular choice here at Glengarry Hospital, Perth. A long established technique and immediately effective; also laparoscopic sterilisation also allows other problems to be checked out and treated at the same time, eg. endometriosis or adhesions.

2. Hysteroscopic female sterilisation

This method is called Essure. It’s a keyhole surgery technique. the gynaecologist places a telescope (hysteroscopy) into the womb and places special plugs in the tubes to do the sterilisation. It takes 3 months before the tubes are blocked. An X-ray, HSG or HyCoSy is needed to confirm they’re blocked. Occasionally this sterilisation doesn’t work, or the plugs are expelled before they fix in place. It’s irreversible – and difficult to remove the plugs.

3. Female sterilisation at Caesarean section

We can easily take portions of the Fallopian tubes out when we do a Caesarean section. It adds about 5 minutes to the operation. It’s slightly more likely to fail than if done using keyhole surgery sometime after the birth. The failure rate is probably about 1/100.

4. Female sterilisation by having a hysterectomy

This is usually done if there are other problems like fibroids, and heavy or painful periods and the hysterectomy is wanted to sort out those problems. This is a much bigger procedure than the female sterilisation operations discussed above.
 

Laparoscopic sterilisation

What are the types of laparoscopic sterilisation?

There are two main ways of performing laparoscopic female sterilisation (a type of keyhole surgery).

The first, more common, method of laparoscopic sterilisation is where the gynaecologist places specially designed clips on the tubes. These clips crush the tubes causing a small portion to be blocked. The clips remain in the body. Sometimes they migrate but they’ve done their job and this rarely causes problems. Sometimes the clips may be thought to cause pain afterwards – the so-called sterilisation syndrome. this is rare, but the clips can be removed- they’ve done their job of sterilisation. If you change your mind, an attempt at reversal with reconnection of the tubes may be tried following this type of sterilisation, but reversal is unreliable with only about a 60% success rate.

The second method of laparoscopic sterilisation is to remove both Fallopian tubes completely. This is a more involved procedure, and is more costly. It’s probable that the failure rate is less with this method than clip sterilisation. Also, it has the advantage of leaving no clips in the body. This method of sterilisation can not be reversed, with IVF necessary if you change your mind and want to get pregnant. A probable additional benefit of this type of sterilisation, is that it probably reduces the life-long risk of ovarian cancer by about 50%. It is thought that many “ovarian” cancers actually originate from the ends of the Fallopian tubes, so removing them prevents this from happening.

 

What happens at laparoscopic sterilisation?

Both types of female sterilisation by laparoscopy are day case operations done at Glengarry Private Hospital in Perth. A general anaesthetic is used. The gynaecologist places a camera through a small incision in the tummy button. With the clip laparoscopic sterilisation method, a tiny incision is made above the pubic bone to pass our instruments. The Fallopian tubes are clipped blocking the tubes, completing the sterilisation. Any pelvic abnormalities found may be treated at the same time eg. endometriosis and adhesions. If the second more complex sterilisation operation is requested ie. removal of the tubes, this requires two tiny incisions on each side of the abdomen, instead of the single middle one. This female sterilisation operation takes longer and is more expensive than the one above.

 

Important points

Laparoscopic female sterilisation is an irreversible procedure

This operation should be regarded as permanent. Most women who change their minds end up having to have IVF. Sterilisation reversal is not that successful, can only be used when clips are used and is very expensive.

Failure rate of laparoscopic sterilisation

Women occasionally get pregnant after a laparoscopic sterilisation operation. The pregnancy rate after clip female sterilisation is reported to be 1 in 200-500 – the tubes can rejoin together and become open again. Even if you have the tubes completely removed, pregnancy can still occasionally occur! If you did become pregnant after female sterilisation, the pregnancy might be ectopic and therefore life-threatening, so you would need to see a doctor ASAP if you found you were pregnant.

Laparoscopic sterilisation risks

Laparoscopic sterilisation is generally very safe keyhole surgery. Serious bleeding or damage to the bowel or bladder are the most important complications, which is said to occur in 1 in 500 cases. Special techniques are used to minimise these rare but severe risks. Minor infections or bruises are more common and settle quickly with time and/or antibiotics.

 

After laparoscopic sterilisation

Laparoscopic female sterilisation is normally a day-case operation done at Glengarry Private Hospital, Perth. You’ll come in for the day having had no food or drink for 6 hours beforehand. Afterwards you’ll probably feel drowsy, which will wear off quickly. You’ll need someone to take you home and be with you overnight.

 

Will it be painful after the female sterilisation?

It’s usually not too bad. Most women are able to walk out of Glengarry private hospital after their laparoscopic sterilisation after a few hours. There may be some pain or discomfort for up to a week, but pain relief is supplied. Sometimes there is pain in the shoulders – this is normal and will settle. Patients should rest up for a few days and take the rest of the week off work.

 

Incisions

These should be kept clean and uncovered. Bathe & dry thoroughly but gently. If they become red, get some antibiotics – the earlier the better – it may be a minor infection (that 1 in 20 women get despite getting antibiotics during the surgery). The stitches will dissolve and come away themselves in time. They do not need to be removed.

 

When can I drive after laparoscopic sterilisation?

Usually after a few days when you feel ready and the pain has settled.

 

When can I go back to work?

Have the rest of the week off. A sickness certificate is automatically provided.

 

When can I have sex?

When you feel ready – usually after a week or so. Continue usual contraception until the next period, or as advised.

 

Note

Any surgical or invasive procedure carries risks. Before proceeding, you should do your own research. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. For instance, your GP’s opinion will be very helpful. Of course, you may have already discussed this with your GP before referral.


Female sterilisation

A permanent method of contraception


PEARL obstetrics | gynaecology

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