Sterilization (medicine)

Sterilization
Background
Birth control type Sterilization
First use Ancient
Failure rates (first year)
Perfect use under 1%
Typical use under 1%
Usage
Duration effect Permanent
Reversibility Difficult and expensive, Vasectomy reversal & tubal reversal may be possible
User reminders 3 negative semen samples required following vasectomy
Clinic review None
Advantages and disadvantages
STD protection None
Benefits Permanent methods that require no further user actions
Risks Operative and postoperative complications.

Sterilization (also spelled sterilisation) refers to any of a number of medical techniques that intentionally leave a person unable to reproduce. It is a method of birth control. For other causes of sterility, see infertility.

Sterilization methods include both surgical and non-surgical, and exist for both males and females. Sterilization procedures are intended to be permanent; reversal is generally difficult or impossible.

Contents

Methods

Surgical

Surgical sterilization methods include:

  • Tubal ligation in females, known popularly as "having one's tubes tied". The Fallopian tubes, which allow the sperm to fertilize the ovum and would carry the fertilized ovum to the uterus, are closed. This generally involves a general anesthetic and a laparotomy or laparoscopic approach to cut, clip or cauterize the fallopian tubes.
  • Vasectomy in males. The vasa deferentia, the tubes which connect the testicles to the prostate, are cut and closed. This prevents sperm produced in the testicles from entering the ejaculated semen (which is mostly produced in the seminal vesicles and prostate). Although the term vasectomy is established in the general community, the correct medical terminology is deferentectomy, since the structure known as the vas deferens has been renamed the ductus deferens.
  • Hysterectomy in females. The uterus is surgically removed, permanently preventing pregnancy and some diseases, such as uterine cancer.
  • Castration in males. The testicles are surgically removed. This is frequently used for the sterilization of animals, but rarely for humans. It was also formerly used on some human male children for other reasons; see castrato and eunuch.

Transluminal

Transluminal procedures are performed by entry through the female reproductive tract. These generally use a catheter to place a substance into the Fallopian tubes that eventually causes blockage of the tract in this segment. Such procedures are generally called non-surgical as they use natural orifices and thereby do not necessitate any surgical incision.

  • The Essure procedure is one such transluminal sterilization technique. In this procedure, polyethylene terephthalate fiber inserts are placed into the fallopian tubes, eventually inducing scarring and occlusion of the tubes. Following successful insertion and occlusional response, the Essure procedure is 99.74% effective based on 5 years of follow-up, with zero pregnancies reported in clinical trials.[1][2]
  • Quinacrine has also been used for transluminal sterilization, but despite a multitude of clinical studies on the use of quinacrine and female sterilization, no randomized, controlled trials have been reported to date and there is some controversy over its use.[3]

Pharmacological

There is no working "sterilization pill" that causes permanent inability to reproduce, although there have been hoaxes involving fictitious drugs that would purportedly have such effects, notably progesterex.

Psychological effects

Most people undergoing sterilization experience no change in sexual activity, quality of marital relationships or work-related behavior.[4] Few regret their choice.[4] Risk factors for negative consequences after sterilization include:[4]

  • being coerced into the procedure
  • lacking understanding of the consequences of the procedure
  • having health complications after the procedure
  • having an unstable marriage, as it increases the risk of divorce followed by a new relationship in which the couple desires to have children
  • disagreeing with partner about the decision to perform sterilization

See also

References

  1. ^ "Clinical Testing". Essure. Conceptus. http://essure.com/EssurePermanentBirth/control%20methodsbyConceptus/Understanding/ClinicalTesting/tabid/58/Default.aspx. Retrieved 2006-12-12. 
  2. ^ Smith RD (January 2010). "Contemporary hysteroscopic methods for female sterilization". Int J Gynaecol Obstet 108 (1): 79–84. doi:10.1016/j.ijgo.2009.07.026. PMID 19716128. http://linkinghub.elsevier.com/retrieve/pii/S0020-7292(09)00399-3. 
  3. ^ Drugs.com --> Quinacrine. Retrieved on August 24, 2009
  4. ^ a b c http://www.jstor.org/pss/1965814 Philliber, S. G.; Philliber, W. W. (1985). "Social and psychological perspectives on voluntary sterilization: A review". Studies in family planning 16 (1): 1–29. PMID 3983979.  edit

External links


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