Factsheet

Tubal Sterilisation

Date   15 January 2008

WHAT IS TUBAL STERILISATION?

Tubal Sterilisation is a permanent form of birth control for women. It is an operation to block the Fallopian tubes so that the sperm cannot travel up to meet the ovum (egg) and begin a pregnancy.

THE OPERATION

The most common method is called Laparoscopic Sterilisation. This usually means a general anaesthetic, and a possible overnight stay in hospital.

One or two 1cm incisions are made in the abdomen, one at the navel and one below the pubic hairline. Some doctors only make one incision. A laparoscope (a tiny telescope) is inserted so that the doctor can see the tubes. The tubes are closed off by clips, rings, or simply cutting and tying. Some people are not able to have a laparoscopy - they may have laparotomy. This involves a larger incision, and most women need to stay in hospital for a few days for the incision to heal.

A newer alternative called Essure® allows small flexible micro-inserts to be inserted into each fallopian tube through the vagina, cervix and uterus. No incisions are necessary and it can be done under local anaesthetic. The procedure takes about 30 minutes and most women are able to go home about one hour later.

WHAT TO EXPECT

Periods and menopause (change of life) are not affected by the operation. It also has no direct affect on sexual intercourse or sexual feelings. Some women enjoy lovemaking more when they are not afraid of getting pregnant.

HOW SOON IS THE OPERATION EFFECTIVE?

For laparoscopic methods the operation is effective immediately but birth control should be used right up to the time of the procedure. You should consider continuing to use condoms (male or female), as sterilisation does not protect against sexually transmitted infections.

The Essure procedure usually takes three months to become effective but may sometimes take longer. You should continue to use another method of contraception until the tubes are shown to be completely blocked.

WHERE DOES THE EGG GO?

The egg is still released from the ovary but it is harmlessly absorbed by the body.

COMPLICATIONS

Procedures involving a general anaesthetic may cause nausea or tiredness over a couple of days. After laparoscopy, there may be some abdominal or shoulder pain which also improves over a day or two. It is usually about seven days before a woman feels completely well again. Women who have the Essure procedure under local anaesthetic usually need to only take one day off work afterwards.

As with any operation, complications such as bleeding and infections can occur but they are not common.

COULD THE OPERATION FAIL?

A pregnancy occurs in approximately 2-9 per 1000 operations. Failures can occur even many years after the operation. If a pregnancy does occur there is an increased chance of it being ectopic (outside the uterus) which can cause dangerous internal bleeding.

REVERSAL

Although it is sometimes possible to repair the Fallopian tubes after laparoscopic sterilisation only about 50% of women fall pregnant after the reversal. There is also a higher risk of ectopic pregnancy after reversal.

The Essure method is permanent and cannot be reversed. Sterilisation should only be done if a woman feels absolutely sure she does not want any more children and would be prepared to accept that decision even if her life changed unexpectedly, for example, if she lost a child or began a new relationship.

The decision needs to be your decision - it is probably best not to make such an important decision at times of increased stress or pressure such as just after childbirth or a miscarriage, or when there are financial or relationship problems.

ARRANGING TUBAL STERILISATION

Seek advice from the health centre, family doctor, gynaecologist or public hospital. For information on Essure® go to www.essure.com.au.

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For further information

Contact the Healthline on 1300 658 886.