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Is there any contraindication to sterilisation?
A decision on sterilisation is an intensely personal thing. It is also a profound decision, by virtue of its permanent nature. Ultimately, a woman has to make the final decision, as long as she knows the facts. In this regard, doctors have a duty to advise where they feel the decision may be unwise and likely to be regretted later. This is their only role.
Of course, some women take offence in being told that what they are proposing to do to themselves may not be good - or at least the timing of it is not right. This should never make doctors shy away from their responsibility of giving what they consider to be their best advice.
Hostile reception of a doctor's advice is part and parcel of the job. And the interval is partly meant to allow the woman time to think things through.
What about reversal of sterilisation?
This should never be relied upon as a fall-back plan. Firstly, it may not be available (most hospitals in the UK do not offer this on the NHS, except in very exceptional circumstances); secondly, even when offered, it may fail, as it does in 30 to 40 per cent of cases; and finally, it brings with it the risk of ectopic pregnancy, which in itself can be catastrophic.
What are the potential complications of sterilisation?
It can fail in up to two in every thousand cases, which is really a low failure rate..
It may be technically impossible to perform by the keyhole approach, necessitating a bigger operation, which means a longer (three to four day) hospital stay.
Other internal structures, such as the bowel, may be injured during the procedure, and pelvic infection is a possible complication. There is also a very small risk of serious haemorrhage in case of injury to a major vessel in the abdomen.
While theoretically this looks a worrying list, in practice this is an extremely safe procedure and virtually everybody goes home the same day and resumes normal activities in less than a week.
Is this the only way that sterilisation can be performed?
In the last few years, a different approach to female sterilisation has been available as an option. This does not involve going through the abdomen. Instead the approach is vaginal. It is called hysteroscopic sterilisation. This involves inserting special rods into the tubes approached via the vagina and womb cavity. It is done under telescopic (hysteroscopic) guidance.
This can be carried out while the patient is awake and as an outpatient procedure. It is, however, not yet available in all hospitals. One such method is branded Essure®. This sterilisation method is irreversible.
Is there any alternative to sterilisation for permanent contraception?
Yes. For those in steady relationships, male sterilisation in the form of a vasectomy is just as simple, with an even lower failure rate. It can be performed under a local anaesthetic.
The non-permanent (reversible) forms of long term contraceptives are covered in detail in a dedicated section that can be found here:
Last update: February 27, 2013