Tubal Ligation/Vasectomy

What are Tubal Ligation and Vasectomy?

These two procedures are permanent methods of birth control. Voluntary sterilization is usually considered by people who have decided that their family is complete. It may also be considered to prevent the possibility of a hereditary disease being passed on to children, when a woman's health could be endangered by pregnancy, or when long-term use of contraceptives proved unsuitable or unsatisfactory.

What is Tubal Ligation?

Tubal ligation is the female sterilization operation. In this procedure, the Fallopian tubes, which carry the ripe egg from the ovary to the uterus each month, are cut and sealed off. This makes a woman unable to become pregnant and, therefore, no further birth control precautions are necessary.

Are There Different Methods for Tubal Ligation?

Tubal ligation is performed in a hospital, usually under general anesthetic. The doctor will use one of three different methods:

1. Abdominal method: A 3 to 4 inch incision is made just above the pubic hair. The Fallopian tubes are cut, tied, and a section of each tube removed. The ends may be sealed or sewn into surrounding tissue.

2. Laparoscopy method: One or two tiny incisions are made in the abdomen, in or near the bellybutton. The laparoscope, a slim, lighted viewing tube, is inserted and a cauterizing instrument is passed through it or through a second incision. Cautery burns seal off each tube in turn.

3. Vaginal method: One incision is made at the top of the vagina behind the cervix. The tubes are located, cut and tied. There are no external scars in this procedure.

The operation usually takes 15 to 30 minutes. The hospital stay varies: it may be as short as eight to 24 hours or as long as two to three days, depending on the type of procedure.

Are There Complications?

A tubal ligation is a very safe procedure; however, with any surgery there is the possibility of infection, bleeding or unusual pain or swelling afterwards. A general anesthetic also carries a very slight risk of complications.

Does Tubal Ligation Affect Your Interest In Sex Or Sexual Performance?

NO! Female hormones will continue to be produced in the ovaries and an egg will be released each month until menopause. The egg will disintegrate at the end of the blocked off tube. The menstrual cycle will continue as before. Many couples state that elimination of fear of pregnancy contributes to increased sexual pleasure. Sexual intercourse should not be resumed after the surgery until your incision has healed completely, and your doctor advises it. This can be as long as six weeks in the case of a vaginal procedure.

How Soon Does It Work? How Effective Is It?

Sterilization by tubal ligation is effective immediately and is almost always 100% effective. There is a remote chance of the tubes reconnecting after surgery, so in the event of a missed period you should contact your doctor.

Can Tubal Ligation be Reversed?

Very Rarely. You should decide on tubal ligation on the understanding that it is a permanent, irreversible method. There is a list of questions at the end of this section to assist you in making your decision.

Can a Single Woman Get a Tubal Ligation?

There are no legal obstacles to a single woman having a tubal ligation. Some doctors, however, are less willing than others to do this! Generally, a woman who is mature and has sound reasons for her decision should have little difficulty in obtaining the surgery.

How Do I Arrange for a Tubal Ligation ?

Your family doctor will refer you to a gynecologist. There is usually a six week to three month waiting list for hospital space and the cost of hospitalization is covered by Ontario Health Insurance Program (OHIP).

A tubal ligation may also be performed shortly after delivery or along with a therapeutic abortion. This is an option to be discussed with your doctor.

How long is the Recovery Time?

Your recovery time will vary according to the type of procedure your doctor uses. Laparoscopy usually requires the shortest recovery period. Plan to avoid any heavy activity for several days following your surgery. If you have young children who require lifting, it would be advisable to have help with that for up to a week.

Be sure to return to your doctor for a checkup following surgery and report any signs of fever, bleeding or unusual discomfort to him/her right away.

What is a Vasectomy?

Vasectomy is the male sterilization operation. In this procedure, the tubes that carry the sperm are cut in order to prevent sperm from reaching the outlet into the penis.

How is a Vasectomy Performed?

A vasectomy may be performed in a doctor's office or in a hospital, depending on the physician's preference. The scrotum, or sac, that contains the testicles is shaved and cleansed before the procedure. Under local anesthetic, one or two small incisions are made in the skin of the scrotum and each vas deferens (sperm-carrying tube) is drawn out. The tubes are cut and usually small sections are removed. The ends are tied off and the small incisions in the skin are closed with a few stitches. The whole operation seldom takes more than half an hour and the man may return home at once. Some bruising and tenderness in the area can be expected. Light duties may be performed the next day; heavy work within a week or less.

Are There Complications? How Effective Is It?

As with any minor surgical procedure, there is the possibility of complications such as infection, bleeding, or unusual pain or swelling afterwards. Careful attention to the doctor's instructions will minimize the chance of such problems. There is no evidence of long-term problems following vasectomy. A vasectomy is almost always 100% effective, but in very rare instances the tubes have been known to rejoin.

Is Vasectomy Effective Immediately?

NO! Although sexual relations may be resumed within one to two weeks following the procedure, OTHER BIRTH CONTROL MUST BE USED. The sperm storage duct will contain sperm at the time of the operation; therefore, it is important to continue contraception until negative sperm tests have proven the operation a success. This requires at least 15 ejaculations. Sperm tests are performed on samples of the seminal fluid collected by the patient and examined under a microscope.

Will Vasectomy Change Your Interest in Sex or Sexual Performance?

NO! It is a fact that vasectomy produces NO CHANGE in the formation or action of the male sex hormone, but only prevents sperm from passing up through the vas to mix with the seminal fluid. Biologically, there is no effect on the man's ability to have an erection and to feel usual or normal sensations during intercourse. He discharges what appears to be normal seminal fluid in terms of colour and amount. (Sperm make up only 10% of the volume of the ejaculate.) However, this fluid is now free of sperm and this no longer capable of causing pregnancy.

What Happens to the Sperm?

Following the vasectomy, sperm continues to be formed in the testicles and passes up the vas deferens to the blocked area. Since they cannot proceed further, the sperm eventually disintegrate. They are absorbed into the local circulation and later excreted as other waste products in the body.

Is Vasectomy Reversible?

Vasectomy should be considered an irreversible procedure. Some success with rejoining the tubes has been reported, but a man considering a vasectomy should understand that it is intended to make him permanently sterile.

Can a Single Man Have a Vasectomy?

There are no legal obstacles to an unmarried man having the operation. He must, however, satisfy his doctor that he is a mature person and his reasons are sound.

How Do I Arrange for a Vasectomy?

Your family doctor will refer you to a general surgeon or urologist. Ontario Health Insurance Plan (OHIP) covers the cost.
 

Reproduced from information supplied by Alberta Health Services Family Planning Clinic.