Introduction
This pamphlet is to sensitize to the chirurgical sterilisation. It is an efficient and permanent contraception method possible for men and women.
Even if different reconstructions surgeries are possible, the couple interested in the sterilisation as a contraceptive method must understand the irreversibility of that option. Effectively, the results of a recanalization are usually disappointing. In that case, the desire of wanting another child must be excluded. For that reason, the decision of having a chirurgical sterilisation has to be made in a calm period of time and a peace minded reflexion. An appointment with a health professional is essential to measure all of the benefits and disadvantages of the procedure and to learn more about the different alternatives options possible.
Vasectomy
Description
The vasectomy is a minor chirurgical intervention, but permanent that blocks the way to sperms to seminal vesicles by sectioning the vas deferens. This operation is done during a local anesthesia and lasts for 10 to 15 minutes. It is easier and includes less risk of complications than the tubal ligation.
Two different techniques are possible: the “classical” method (practiced at the Rimouski’s hospital) and the “no bistoury” one (practiced in private clinics in Quebec City). The principal difference between the two methods is the way the doctor will reach your vas deferens, not how he will block them. Therefore, there is no difference of effectiveness between the two techniques.
Efficiency
The efficiency of the vasectomy is 99.9% but does not assure sterilization immediately. Many sperms can stay in the vas deferens and in the glands after the operation, which is why a spermogram will be done 2 to 3 months after the intervention to confirm the sterility. In some cases, more than one test will be needed before the levy is really negative but most of the men will officially be sterile after 3 months. Very rarely, a natural recanalization may occur and your doctor will have to redo the surgery.
Contraindications
In the medical sphere, there are very few contraindications. The principal is your uncertainty to want another child in your life
Benefits
It is a minor intervention that can release you about contraception’s worries without any alterations in your sexual life or general health. You will keep having erections and ejaculations normally, but your ejaculation liquid won’t contain sperm anymore.
Complications
As well as any surgeries, some very rare complications may occur: some bleeding, an infection, and a testicle discomfort or chronicle pain. A certain controversy questioned the possible link between vasectomy and prostate cancer. However, the actual researches cannot confirm those theories.
Practical tips
The morning of the intervention, wear tight underwear and shake your penis and scrotum (skin wrapping your testicles). Do not take any aspirin or anti-inflammatory during the 7-10 days before the surgery.
After the vasectomy:
- In the first 48 hours, apply some ice for 20-30 minutes, 3 to 4 times a day to limit swelling and pain. The blue coloration will be gone in 7 to 15 days after the intervention.
- If you feel any pain, use an analgesic drug such as acetaminophen (Atasol, Tylénol). Aspirin must be avoided for the first days of convalescence.
- Take a shower or a bath when you take the band aid off the day after the surgery.
- Avoid any intense sports or activities that need you to lift heavy things for a week. Efforts can cause bleedings or scrotum swelling.
- Protected sexual relations with an additional contraceptive method can be back in your life after 4 or 5 days if you don’t feel any pain.
- The day of the surgery, an information pamphlet and a jar will be handed to do the prescribed spermogram.
- As long as the sterilization is not confirmed, consider you as fertile and use another contraceptive method. If your partner is late in her period, use a pregnancy test.
The tubal ligation
Description
The tubal ligation is a permanent surgery preventing sperm to reach the ovule and a possible fecundation. The microscopic ovule decays in the Fallopian tube and is naturally eliminated by the body. This intervention is done by different methods. The most common is the laparoscopic ligation. It eases the convalescence for most of the women and limits the possible aftermath of the surgery. The tubal ligation can be performed in the meantime of a caesarean.
Effectiveness
It efficiency rises to 96.9% in the best conditions. Even if it is very rare, a pregnancy can always be possible if the case if a recanalization.
Method
Laparoscopic: Two small incisions are done, one around 7-10 mm under the belly button et the other 5-8 mm over the pubis bone. For the first cut, the doctor inserts the head of a lighted camera (laparscope) to see the tubes, the uterus and the ovaries. In the other incision, the physician introduces special instruments to grasp the tube and sections, ties or burns it with an electric current. Sometimes, the doctor will have to make a third small incision to complete the surgery. Most of the time, the tubal ligation is a “one-day” surgery and lasts 30 minutes. The convalescence requires around 2 to 5 days.
Anesthesia
A general anesthesia is usually used.
Practical tips
Before the ligation: You will have to proceed to different preoperative exams depending of your general health situation. You must be on an empty stomach for 6 to 8 hours before the surgery and avoid wearing any jewelry, making up or nailing polish for the day of the intervention.
After the ligation: You will have to rest for a couple days or weeks depending of the opinion of your doctor. Take the time to check up with your surgeon if the stitches will melt or if you will have to take them off. The procedure won’t have any effect on your menstrual cycle or on your sexual pleasure. Your periods will occur at the same frequency they use to happen and, when your doctor will recommend you to, you could have sexual relations. The tubal ligation is a very efficient contraceptive method but does not prevent from any S.T.I.
Complications
The risks related to the intervention are very weak and are mostly related to the laparoscopic and the general anesthesia. Bleeding, an infection, an allergic reaction to the anesthesia or any organ trauma happens in 1 to 4% of the cases.
During the week after the intervention, you may feel:
- Slight nausea or stun caused by the medication or the procedure
- Some light pink bleeding around the incisions
- Pain at the operations sites or any abdominal pain
- Abdominal bloating
- Vaginal bleeding looking like menstruations caused by the manipulations during the procedure
- Sore throat and hoarsely related to the breathing tube used for the general anesthesia
- Little neck and shoulders pain
- General tiredness
Usually, those discomforts can be relieved with analgesic pills such as Atasol or Tylénol.
NOTE
The pregnancy risks after a tubal ligation is lower than 1%. If you are pregnant, you must consult your physician quickly because your pregnancy might be inside of one of your tube (ectopic pregnancy) after the intervention.
Last update : December 2014