Voluntary sterilization of women: the pros and cons of the operation, the consequences, reviews. Recovery after surgery. Video: how female sterilization is done

900 performed bilateral vasectomy
765 with the aim of surgical contraception
81 on medical indications
99 % reached positive effect

About male sterilization

Male sterilization is one of the most effective and modern ways appearance warnings unwanted pregnancy at a woman. Sterilization is carried out only in those men who are already have children, so how to restore childbearing function after the operation is not possible.

The operation consists in blocking the ducts carrying the seed to prevent patency in sperm. All other features characteristic of a man (attraction, erection, ejaculation) are preserved. Male sterilization is a widespread, fairly simple and easy to perform procedure, acting as a reliable method of male contraception.

All indicators point to the superiority of male sterilization over surgical contraception in women. Therefore, this method is widely used in the world, especially widespread in the countries of Southeast and South Asia.

Video "Vasectomy - male surgical contraception"

Benefits of male sterilization

Male sterilization is the most effective method contraception. The probability of pregnancy in women is less than 0.1%, and only if the vas deferens can be repaired, which indicates an incorrectly performed operation (crossing another structure). Or, in a very rare cases, when there is congenital anomaly, which manifests itself in the form of a doubling of the vas deferens.

Male sterilization is an excellent method of contraception, but requires a conscious, measured approach.

AT recent times the least traumatic method for male sterilization is increasingly being used, the essence of which lies in the fact that a puncture is used to release the ducts that carry the seed ( puncture), not a cut.

Indications for male sterilization

The indications for the operation are:

Unwillingness of spouses to have children for medical or social reasons;
Intolerance to others existing ways contraception;
Hereditary diseases in men;

Male sterilization is done on men over the age of 35 who already have two or more children. If this operation is required for medical reasons, then in any case, the consent of the patient is required. The thing is that the operation is irreversible, it will not be possible to restore the vas deferens.

The likely percentage of complications in male sterilization is small, but it is with any surgical intervention. The failure rate is less than 0.1%, and only when it is due to the error of the surgeon or to the fusion of the ends of the seminal duct. Before the operation, a man must be absolutely sure of the decision and the choice of such a method of contraception.

Male sterilization is an irreversible operation, acting as a way to prevent the development of pregnancy. The operation should be postponed if the man is unmarried and has no children, and if family problems. The ideal case where the operation is jointly decision men and women.

Conducting male sterilization

Male sterilization in the DeVita clinic is performed under local anesthesia by experienced surgeons with many years of practical experience. The efferent duct is pre-fixed with two fingers and infiltrated with a 1% lidocaine solution.

for maximum comfort after surgery
Patients are accommodated in comfortable double rooms

The incision of the muscle layer and the skin is carried out over the vas deferens, which are isolated and crossed, after which they are tied up. Sometimes doctors remove a small part of the vas deferens to be more reliable (although this is not considered mandatory). In certain cases, the method of closing the crossed ends with the help of fascia is used.

Wounds after male sterilization are closed with absorbable sutures, i.e. there is no need to remove the sutures. The operation takes 20-30 minutes. After the operation, the patient can be discharged from the clinic. Today, male sterilization is one of the most reliable and effective surgical methods on contraception in men.

Feedback on male sterilization

Nikolay P. 44 years old.
I doubted for a long time. Two children from the first marriage, one from the second. Perhaps he did not agree to sterilization, but unfortunately other methods of contraception are not suitable for his wife for health reasons. The operation itself - 20 minutes, did it personally chief physician- R. Salyukov. Feels like - I remember there was a little discomfort when squatting or when you push for about a week. They completely stopped using protection after 2 months, just in case I did a spermogram - everything is clean. Maybe this is subjective, but it seems that after the operation something has changed, well, somehow in better side in bed, although I may be wrong. If anyone reading my review is thinking about sterilization, I advise you to think over and weigh everything again, because. for men - must be serious occasion to lie under the scalpel.
I wish you all health and male strength.

It might be interesting

Urologists of our clinic performing male sterilization

Doctor urologist, member of the Russian and European Society urologists, candidate medical sciences.

Doctor of the highest category. Candidate of Medical Sciences. Member of the Russian and European Society of Urology, Candidate of Medical Sciences. In practice, he uses modern minimally invasive and endoscopic methods treatment with botulinum toxin type a and sacral neuromodulation.

More than 15 years of professional experience.

In 2007 he graduated from the Faculty of social medicine » GKA im. Maimonides. Member of the Russian Society of Urology. It has practical experience work in the field of neurourology - treatment and prevention neurogenic disorders urination, hyperactive Bladder.

Performs a comprehensive urodynamic study.

Pediatric urologist-andrologist

In 1996 he graduated from the medical faculty of the Kabardino-Balkarian Order of Friendship of Peoples state university. Doctor of the highest category. Candidate of Medical Sciences. Has additional professional retraining in pediatric surgery, pediatric urology, endoscopy.

Work experience in the specialty 16 years.

The cost of male sterilization in our clinic

Book a consultation about male sterilization

Questions from users on our website about male sterilization

Peace to you. I'm interested in the cost of a vasectomy, my age is 44 and we have three kids. I am not a supporter of sterilization, but my wife

does not let him down. I'm tired of condoms, I want them without ... But my wife doesn't even want to hear. In general, tell me the price of this operation, I'll think if I pull it and I'm not sure if I decide. Thanks to.

Doctor's answer:

Standard operation "vasectomy" in our clinic without cost laboratory diagnostics and the cost of a doctor's examination - 15,000 rubles.

Can you give me a vasectomy please? I am 27, my son is 3 years old, my wife was in the hospital for 6 months with taxicosis during pregnancy. We are all the time

were protected after the first birth, but the stubborn spermatozoon gnawed through the prezik - now she is pregnant again. If your answer is no, then when young guys change sex, do they bypass article 37 by the monetary equivalent? You love the law so much that you can’t understand and help - alimony is paid from the age of 35 ?? Or for a third child? That's why masturbators live in Russia

Doctor's answer:

Hello. Vasectomy in our clinic can be performed for men over the age of 35, provided there are 2 or more children.

Doctor's answer:

Hello. Article 37 - “Medical sterilization as a special intervention to deprive a person of the ability to reproduce offspring or as a method of contraception can be carried out only on the written application of a citizen not younger than 35 years old or having at least two children. Those. We are legally entitled to do this for you. surgical intervention if you are 35 years of age or older or have more than 2 children. Unfortunately we have to refuse.

Healthy women are fertile until the age of 50-51. healthy men capable of fertilization throughout life. Since most couples already have the desired number of children by the age of 25-35, they need effective contraception for the remaining years.

Currently voluntary surgicalcontraception(or sterilization) (DHS) is the most common method of family planning in both developed and developing countries.

DHS is an irreversible, most effective method of contraception not only for men, but also for women. At the same time, it is the safest and most economical method of contraception.

Frequent use of local anesthesia with little sedative effect, improvement surgical technique and better medical staff qualifications have all contributed to improving the reliability of DHS over the past 10 years. When performing DHS in postpartum period by experienced staff under local anesthesia, a small skin incision and advanced surgical instruments, the duration of the stay of a woman in labor in the maternity hospital does not exceed the usual length of bed-days. Suprapubic minilaparotomy(usually performed 4 or more weeks after delivery) can be done at outpatient settings under local anesthesia, as in the laparoscopic method of surgical sterilization.

Vasectomy remains a simpler, more reliable and less expensive method surgical contraception, how female sterilization although the latter remains the more popular method of contraception.

Ideally, a couple should consider using both irreversible methods of contraception. If female and male sterilization were equally acceptable, then vasectomy would be preferred.

First surgical contraception began to be used for the purpose of improving health status, and later - for broader social and contraceptive considerations. In almost all countries, sterilizations are performed for special medical reasons, which include uterine rupture, multiple caesarean sections, and other contraindications for pregnancy (for example, serious cardiovascular disease, the presence of multiple births and a history of serious gynecological complications).

Voluntary surgical sterilization in women is safe method surgical contraception. Most data from developing countries indicate that the mortality rate for such operations is approximately 10 deaths per 100,000 procedures, while for the United States the same figure corresponds to 3/100,000. Maternal mortality in many developing countries is 300-800 deaths per 100,000 live births. From the above examples, it follows that DHS almost 30-80 times safer than a second pregnancy.

Mortality rates for minilaparotomy and laparoscopic sterilization methods do not differ from each other. Sterilization can be carried out immediately after childbirth or termination of pregnancy.

Female sterilization is a surgical blocking of the patency fallopian tubes in order to prevent the fusion of the sperm with the egg. This can be achieved by ligation (ligation), the use of special clamps or rings, or electrocoagulation of the fallopian tubes.

Method failure rate DHS significantly lower than other methods of contraception. The rate of "contraceptive failure" when using conventional methods of occlusion of the fallopian tubes (Pomeroy, Pritchard, Silastic rings, Filshi clamps, spring clamps) corresponds to less than 1%, usually 0.0-0.8%.

For the first year of the postoperative period total number cases of pregnancy is 0.2-0.4% (in 99.6-99.8% of cases, pregnancy does not occur). Significantly less incidence of "contraceptive failure" in subsequent years after sterilization.

Pomeroy method

The Pomeroy method is the use of catgut to block the fallopian tubes and is a fairly effective approach to conducting DHS in the postpartum period.

In this case, the loop of the fallopian tube is tied with catgut in its middle part, and then excised.

Pritchard method

The Pritchard method makes it possible to save most of the fallopian tubes and avoid their recanalization.

During this operation, the mesentery of each fallopian tube is excised in the avascular area, the tube is ligated in two places with chromic catgut, and the segment located between them is excised.

Irving method

The Irving method consists of suturing the proximal end of the fallopian tube into the wall of the uterus and is one of the most effective ways postpartum sterilization.

It is important to note that when conducting DHS by Irving's method the probability of development ectopic pregnancy decreases significantly.

Clips Filshi

Filshi clips are applied to the fallopian tubes at a distance of approximately 1-2 cm from the uterus.

The method is used mainly in the postpartum period. It is better to apply clips slowly in order to evacuate edematous fluid from the fallopian tubes.

Suprapubic minilaparotomy

Suprapubic minilaparotomy or "interval" sterilization (usually performed 4 or more weeks after delivery) is performed after complete involution of the uterus after delivery. At this method sterilization, a skin incision is performed in suprapubic area 2-5 cm long. Minilaparotomy can become difficult with significant overweight female patients adhesive process pelvic organs due to surgery or inflammatory disease pelvic organs.

Before the procedure, it is necessary to exclude the presence of pregnancy. Mandatory laboratory research usually include analysis of hemoglobin in the blood, determination of protein and urine glucose.

Procedure. Before the operation, you should empty your bladder. If the uterus is in the aneversio position, the patient is usually in the Trendelenburg position during minilaparotomy, otherwise the uterus should be lifted manually or with a special manipulator.

Location and size of the minilaparotomy incision. When placing a skin incision above the line, the fallopian tubes become difficult to access, and when it is performed below the suprapubic line, the likelihood of damage to the bladder increases.

A metal lift lifts the uterus so that the uterus and tubes are closer to the incision

Minilaparotomy sterilization uses the Pomeroy or Pritchard method, and also resorts to the use of fallopian rings, Filsch clamps, or spring clamps. The Irving method is not used for minilaparotomy due to the impossibility of approaching the fallopian tubes with this method of operation.

Complications. Complications usually occur in less than 1% of all surgeries.

The most common complications include complications associated with anesthesia, infection of the surgical wound, trauma to the bladder, intestines, perforation of the uterus during its elevation and unsuccessful blocking of the patency of the fallopian tubes.

Laparoscopy

Operation technique. DHS The laparoscopic method can be performed both under local anesthesia and under general anesthesia.

The skin is treated appropriately, while Special attention is given to the treatment of the umbilical region of the skin. To stabilize the uterus and its cervix, special single-pronged forceps and a uterine manipulator are used.

The Veress needle for insufflation is inserted into the abdominal cavity through a small sub-umbilical skin incision, after which a trocar is inserted through the same incision towards the pelvic organs.

The patient is placed in the Trendelenburg position and insufflated with approximately 1-3 liters ( minimal amount required for good visualization of the abdominal and pelvic cavities) nitrous oxide, carbon dioxide or, in last resort, air. The trocar is removed from the capsule, and the laparoscope is inserted into the same instrument. When using bipuncture laparoscopy, the second skin incision is performed under the control of a laparoscope from the abdominal cavity, and in the case of monopuncture laparoscopy, manipulators and other appropriate surgical instruments injected into the pelvic cavity through the laparoscopic channel. To varieties last method refers to the so-called. " open laparoscopy”, during which the peritoneal cavity is opened visually in the same way as in the subumbilical minilaparotomy, after which the canula is inserted and the laparoscope is stabilized; this method of operation prevents the blind insertion of the Veress needle and trocar into the abdominal cavity.

When using fallopian tube clamps, it is recommended that they be applied to the isthmus of the fallopian tubes at a distance of 1-2 cm from the uterus. Silastic rings are placed at a distance of 3 cm from the uterus and electrocoagulation is performed in the middle segment of the tubes to avoid damage to other organs. After finishing this stage operations should ensure complete hemostasis; the laparoscope, and later the insufflated gas, is removed from abdominal cavity and sew up the skin wound.

Complications. Complications with laparoscopy are less common than with minilaparotomy. Complications related directly to anesthesia may be aggravated by the consequences of abdominal insufflation and the Trendelenburg position, especially when general anesthesia. Complications such as damage to the mesosalpinx (mesentery of the fallopian tube) or fallopian tube may follow the placement of fallopian rings on the fallopian tubes, which may require laparotomy to control hemostasis. In some cases, an additional ring is applied to the damaged fallopian tube for the purpose of complete hemostasis.

Treatment of uterine perforation is carried out conservative method. Damage to the vessels, intestine or other organs of the peritoneal cavity can be caused by manipulation of the Veress needle or trocar.

Transvaginal laparoscopy

The transvaginal sterilization method is one of the laparoscopic sterilization methods. The operation begins with a colpotomy, i.e., a mucosal incision is made posterior fornix vagina under the control of direct visualization (colpotomy) or a culdoscope (a special optical instrument).

The transvaginal method of sterilization should be used in exceptional cases, while it must be carried out by a highly qualified surgeon in a specially equipped operating room.

Transcervical surgical sterilization.

Most hysteroscopic methods of sterilization using occlusive preparations (hysteroscopy) are still in the experimental stage.

Hysteroscopy is considered expensive operation and requires special training surgeon, while the efficiency index leaves much to be desired.

In some clinics, as an experiment, a non-operative sterilization method is used, which consists in the use of chemical or other materials (quinacrine, methyl cyanoacrylate, phenol) for occlusion of the fallopian tubes by a transcervical approach.

Sterilization and ectopic pregnancy

An ectopic pregnancy should be suspected whenever signs of pregnancy are observed after sterilization.

According to the United States, 50% and 10% of all ectopic pregnancies after sterilization are due to electrocautery tubal occlusion and fallopian rings or clamps, respectively.

The consequence of the Pomeroy method in the form of an ectopic pregnancy occurs with the same frequency as with the use of fallopian rings.

The onset of an ectopic pregnancy can be explained by several factors:

development of utero-peritoneal fistula after electrocoagulation sterilization;
inadequate occlusion or recanalization of the fallopian tubes after bipolar electrocoagulation, etc.

Ectopic pregnancy accounts for 86% of all long-term complications.

Changes menstrual cycle . It was assumed the development of changes in the menstrual cycle after sterilization, even the term "post-occlusion syndrome" was proposed. However, there is no convincing and reliable data on the existence of a significant effect of sterilization on the woman's menstrual cycle.

Contraindications to sterilization

Absolute contraindications:

Tubal sterilization should not be carried out if:

active inflammatory disease of the pelvic organs (must be treated before surgery);
if you have an active sexually transmitted disease or other active infection (must be treated before surgery.)

Relative contraindications

Special care is required for women with:

pronounced overweight(minilaparotomy and laparoscopy are difficult to perform);
adhesive process in the pelvic cavity;
chronic heart or lung disease.

During laparoscopy, pressure is created in the abdominal cavity and a downward tilt of the head is required. This can impede blood flow to the heart or cause the heart to beat irregularly. Minilaparotomy is not associated with this risk.

Conditions that may worsen during and after treatment DHS:

heart disease, arrhythmia and arterial hypertension;
pelvic tumors;
uncontrolled diabetes mellitus;
bleeding;
severe nutritional deficiencies and severe anemia;
umbilical or inguinal hernia.

How to prepare for sterilization

After deciding on surgical sterilization, you must be sure that you want to use an irreversible method of contraception. You can cancel your decision at any time or postpone your scheduled surgery if you need more time to think.
Take a bath or shower just before the operation. Pay special attention to the cleanliness of the umbilical and hairy part of the pubic area.
Do not eat or drink for 8 hours before surgery.
It is recommended that you be escorted to the clinic on the day of the operation and taken home after the operation.
Take a rest, at least, within 24 hours after surgery; try to avoid physical activity during the first week after surgery.
After the operation, pain or discomfort may occur in the area of the surgical wound or the pelvic region; they can be eliminated by taking simple painkillers in the form of aspirin, analgin, etc.
Rest for two days after surgery.
Avoid intercourse for the first week and stop if you complain of discomfort or pain during intercourse.
To speed up the healing of the surgical wound, avoid heavy lifting during the first week after surgery.
You should consult a doctor if you develop the following symptoms:
If you complain of pain or discomfort, take 1-2 tablets of painkiller at intervals of 4-6 hours (aspirin is not recommended due to increased bleeding).
Taking a bath or shower is allowed after 48 hours; while trying not to tense your muscles abdominals and do not irritate the surgical wound during the first week after surgery. After taking a bath, the wound should be wiped dry.
Contact the clinic 1 week after the operation to monitor wound healing.
At the first sign of pregnancy, contact your doctor immediately. Pregnancy after sterilization is extremely rare and in most cases it is ectopic, which requires urgent measures.

Beware:

increase in body temperature (up to 39 ° and above);

dizziness with loss of consciousness;

persistent and / or increasing pain in the abdomen;

bleeding or continuous discharge of fluid from the surgical wound.

Restoration of fertility after sterilization

Voluntary surgical sterilization should be considered an irreversible method of contraception, but despite this, many patients require restoration of fertility, which is a common occurrence after divorce and remarriage, the death of a child, or the desire to have next child. You need to pay special attention to the following:

restoration of fertility after DHS is one of the most difficult surgical operations requiring special training of the surgeon;
in some cases, the restoration of fertility becomes impossible due to the patient's advanced age, the presence of infertility in the spouse or the impossibility of performing the operation, the reason for which is the sterilization method itself;
the success of the reversibility of the operation is not guaranteed even if there are appropriate indications and the surgeon is highly qualified;
the surgical method of restoring fertility (for both men and women) is one of the most expensive operations.

In addition, there is a possibility of developing complications associated with anesthesia and the operation itself, as with other interventions on the organs of the abdominal and pelvic cavities, as well as the onset of an ectopic pregnancy when fertility is restored after female sterilization. The incidence of ectopic pregnancy after restoration of patency of the fallopian tubes after sterilization by electrocoagulation is 5%, while after sterilization by other methods - 2%.

Before making a decision to carry out surgical recovery patency of the fallopian tubes, laparoscopy is usually performed to establish their condition, and the condition is also determined reproductive system both the woman and her husband. In most cases, the operation is considered ineffective if there is less than 4 cm of the fallopian tube. Reverse operation after sterilization by the method of using clips (Filchi and spring clips) has the maximum efficiency.

Despite the possibility of restoration of fertility, DHS should be considered an irreversible method of contraception. If there are insufficient indications for plastic surgery in women, you can resort to an expensive in vitro fertilization method, the effectiveness of which is 30%.

With these operations, an insignificant segment of the fallopian tube (only 1 cm) is affected, which facilitates the restoration of patency of the tubes. At the same time, the frequency of development intrauterine pregnancy after this operation is 88%. In the case of the use of fallopian rings, a segment of the fallopian tube 3 cm long is damaged and the efficiency of plastic surgery is 75%. The same indicators for the Pomeroy method are 3-4 cm and 59%, respectively. With electrocoagulation, a segment of the fallopian tube with a length of approximately 3 to 6 cm is damaged, and the incidence of intrauterine pregnancy corresponds to 43%. When conducting plastic surgery Fertility restoration uses modern microsurgical techniques, which, in addition to having special equipment, require special training and qualifications of the surgeon.

Now there are many methods of contraception. One of those is female sterilization.

The essence of the method lies in the violation, because it is in this place that the sperm fertilizes the egg.

Sterilization methods

Previously, the operation was performed through an incision in the abdominal cavity. AT this case ligated fallopian tubes and cut them between the threads. This method had high efficiency, since recanalization (recovery) occurred quite rarely. A significant disadvantage was a significant incision, so sterilization was mainly carried out during other operations, for example,.

Now such an operation is performed in the majority with the help of laparoscopy: 3 small punctures are made in the abdominal cavity, a miniature video camera and small-sized endoscopic instruments are inserted inside. Such surgical intervention performed in a gynecological hospital.

The operation for sterilization by laparoscopy of women is performed by two methods: mechanical blockage of the pipes and electrocoagulation (cauterization).

The first option involves the imposition of a ring or two clips on the fallopian tube and its intersection. Clipping itself is a less reliable option, as the clip may cut through and the pipe will recover. The operation, depending on the technique and technique, lasts 10-30 minutes.

In the second case, the pipe is stopped by an electrocoagulator or electrotweezers. As a result, its walls stick together under the influence of current.

There is also a method of culdoscopy, which involves intervention through the vagina.

A mini-laparotomy consists of making a puncture in the pubic area, at least 5 cm in size.

A surgical ligation of the fallopian tubes can be performed in the following cases:

When performing other abdominal surgery;
At inflammatory pathologies pelvic organs;
With endometriosis;
In parallel with operations on the abdominal cavity or pelvic area.

The operation on the abdominal cavity leaves a scar, with laparoscopy - small scars, which will later be invisible, culdoscopy leaves no traces.

As mentioned above, sterilization can be performed after caesarean section, in the second phase of the menstrual cycle, and after natural childbirth- 2 months later.

Absolute contraindications

As with any other surgical intervention, sterilization has its own contraindications.

Among them:

Pregnancy;
Acute gynecological inflammatory diseases;
Active sexually transmitted diseases (treatment is carried out before surgery);
Significant adhesions of the abdominal cavity and small pelvis, which complicate surgical intervention;
The presence of significant body fat;
Umbilical hernia;
Violation of blood clotting;
Diabetes;
Chronic diseases of the lungs and heart.

During laparoscopy, pressure is created in the abdominal cavity and a downward tilt of the head is necessary. Doing so can block blood flow to the heart or disrupt the regularity of the heartbeat.

Pros and cons of sterilization for women

A significant disadvantage is the relative irreversibility of the procedure. But this event allows you to get rid of contraception problems once and for all, this is especially important for women after 35 who want to lead a full-fledged sexual life but limited in acceptance. hormonal contraceptives cannot use intrauterine devices.

Experts say that the operation reduces the risk of inflammation of the appendages, because the main route through which the infection enters is blocked.

Many are interested in whether sterilization affects hormonal background. You can definitely answer that no failure will occur, because the fallopian tubes do not produce hormones. This is what the ovaries do.

After the procedure, ovulation persists, menstruation and PMS occur. In addition, a woman can be artificially fertilized because eggs continue to be produced.

Sterilization of a woman is irreversible, so she may have sexual contact without contraception, because pregnancy will not occur.

This is a one-time procedure, so there are no postoperative costs. Need to buy condoms birth control pills disappears.

It is worth noting that sterilization does not protect against sexually transmitted infections.

Most often, such an event is needed by those who do not want to have children in the future, do not have the opportunity to use other methods if there is a risk of transmission hereditary disease future child.

It is not recommended to use this method for women under 30 who do not have children, who have had problems with pregnancy, without having a permanent relationship, at the whim of a sexual partner. It should be borne in mind that the consequences may be irreversible even if great desire return childbearing function.

After surgery, as well as during such, heart disease may worsen, arterial hypertension, arrhythmia. There is a possibility of developing pelvic tumors and bleeding. It may also develop diabetes, umbilical or inguinal hernia, severe nutritional deficiency.

Consequences of sterilization for a woman

The operation is carried out only voluntary consent female patients. Since the event leads to the elimination of the childbearing function, much attention is paid to counseling.

The woman is told in detail about sterilization, the advantages and disadvantages of this method of contraception. The information is objective and is provided to help the lady weigh the pros and cons and make an informed and correct decision.

The woman must be told that:

There are other ways to prevent unwanted pregnancy, for example, male sterilization is a less dangerous procedure;
The suppression of the tubes is a surgical intervention, that is, a full-fledged operation with all possible consequences, including postoperative period. Hematomas may occur, which will resolve in the future, but at first they will cause discomfort. There is a risk of damage during the procedure internal organs if the method of intervention through the abdominal cavity is chosen;
After a successful operation, a woman will not be able to get pregnant. naturally. About 3% of patients wish to return the childbearing function. Although modern surgery allows you to do this, but the process is complex, difficult and does not always lead to the desired result;
The disadvantages include the possibility of an ectopic pregnancy after sterilization. When appropriate signs appear, doctors first of all consider this option. Fertilization is explained by several factors: the development of a utero-peritoneal fistula after electrocoagulation, inadequate occlusion or recanalization of the tubes.

Female sterilization is a major operation in which the woman needs spinal anesthesia. Among the contraindications for surgery are acute diseases hearts, infectious lesions. Patients who have bladder cancer are not allowed to undergo the procedure.

Before the start of the operation, the patient is given sedative. After the drug begins to work, the surgeon makes a couple of small incisions just below the navel to access each of the two fallopian tubes. Traditional sterilization is performed by cutting and then bandaging or cauterizing the organ to prevent the passage of a fertilized egg. Alternatively, special rings or clips can be used. After that, the patient is sutured and is under the supervision of specialists until her condition stabilizes.

Another method of absolute sterilization can be surgical removal uterus and, depending on the health of the patient, her ovaries. This method is much more dangerous and can cause a number of complications in the future. A hysterectomy is used if a woman has appropriate health conditions (for example, ovarian cancer), but the operation is also possible in women who do not suffer from any ailments.

Efficiency

The overall success rate for ligation of fallopian tubes reaches 99%. One of the complications is the occurrence of an ectopic pregnancy, which can threaten the life of the patient. Within 3 months after surgery, a specialized x-ray may be required to confirm that the fallopian tubes are completely blocked and there is no chance of pregnancy. The chance of getting pregnant may increase slightly if, over time, the organ heals and rebuilds on its own, which will allow fertilization.

Sterilization is irreversible and cannot be considered as a temporary method of preventing pregnancy. Restoration of the fallopian tubes by means of microsurgery is possible, but the acquisition of fertility in this case is not guaranteed. In vitro (artificial) fertilization is an alternative option if the patient still decides to endure and give birth to a child.

Although in both cases surgical intervention is required. The procedure of male sterilization is called in medicine vasectomy, which we will discuss later in the article in a simple language for the reader.

This is a technically easy intervention requiring only local anesthesia, can be done within half an hour in a medical office.

Sterilization procedure

The technique consists in cutting the channels through which the sperm flows. Excision of a part of the vas deferens in the most accessible place from the point of view of anatomy, that is, close to the surface from the side of both testicles. Carefully pulling the skin from the scrotum to the testicles, you can easily feel for the protruding canals, which, when touched with your fingers, are like two solid cords.

The doctor applies local anesthesia, then makes two small incisions on both sides of the scrotum, finds the protruding channels, cuts them. Removes a small section from each of them and bandages the edges of the cut canals. Operation completed.

Effectiveness of Vasectomy

After a vasectomy (as this operation is called), a man does not experience any pain. After 1-2 days, he can return to an active sexual life.

But be careful, at first the man is not sterile. The fact is that in the part of the canals located above the ligation there are millions of spermatozoa!

Therefore, use for 2 months (this period is enough for the ejaculation of the remaining spermatozoa). You can also do a semen analysis: if there is a double-digit sperm count, the man is considered sterile.

Is it possible to return everything back?

Vasectomy should be considered as an irreversible operation, despite the fact that the restoration of the passage of spermatozoa seems to be possible in 70% of cases.

Less than 25% of men regain fertility after sterilization. No more or less acceptable explanation for this fact has yet been found. Most likely, after a vasectomy, a man develops antibodies that build a defense system against his own sperm.

Even very fertile men have been found to have antibodies. So what to do? Experimental studies a plastic plug is being developed that is placed in the vas deferens, which, at the request of a man, can be removed.

Another way is to install a micro-valve in the channels, capable of opening and closing like a tap. However, all these studies have not yet been successful.

Harmlessness of the method

Danger wears psychological character: a man is afraid of losing his erection, orgasm and ejaculation. In fact, no change in sexual behavior not happening. male hormones continue to be developed. The amount of sperm excreted is almost the same, spermatozoa make up only a small part of it. The prostate and vesicles provide sufficient secretions to leave semen.