What is tubal sterilization? Positive and negative consequences of sterilization for women

Sterilization of women– a surgical method of contraception, which consists in artificially blocking the patency of the fallopian tubes, preventing the fusion of the egg with the sperm. Sterilization of women can be carried out by ligation (ligation), electrocoagulation, clipping of the fallopian tubes with special staples, etc. Sterilization operations for women can be performed through minilaparotomy, laparoscopic or transvaginal access. The contraceptive result of various methods of sterilization of women is 99.6-99.8%.

Indications and contraindications

Sterilization in women is carried out with the consent of the patient if she does not want to have any more children, provided she is over 35 years old and has 2 or more children; if there is a risk of pregnancy and childbirth for health reasons (severe forms of cardiovascular, nervous, endocrine and other diseases, anemia, heart defects, etc.), with contraindications to the use of other methods of contraception. A woman's decision to undergo sterilization is documented in legal documents.

Absolute contraindications to tubal sterilization of women are pregnancy, the active stage of inflammation or infection of the pelvis. Relative limitations include significant obesity, which complicates minilaparotomy or laparoscopy, severe adhesions in the pelvic cavity, and chronic cardiopulmonary pathology. When planning sterilization of women, it should be taken into account that such an operation can aggravate the course of arrhythmia, anemia and arterial hypertension, the development of pelvic tumors, inguinal or umbilical hernias.

Sterilization surgery in women can be performed in the second phase of the menstrual cycle, during a cesarean section, within the first 48 hours or 1.5 months after natural childbirth, immediately after an uncomplicated abortion, during gynecological operations. Sterilization does not lead to disruption of menstrual function and sexual behavior. The operations are performed under epidural or general anesthesia.

Types of sterilization

The Pomeroy and Parkland sterilization methods involve ligation of the fallopian tubes with catgut followed by dissection or resection of a segment of the tube. During sterilization using the Pomeroy method, the fallopian tube is folded into a loop in its middle part, then tied with catgut and excised near the ligation area. The Parkland technique is based on the application of ligatures in 2 places of the tube, followed by resection of its internal segment. Sterilization of women using the Irving method is carried out by sewing the distal ends of the fallopian tubes into the wall of the uterus.

Mechanical methods of sterilization involve blocking the fallopian tubes with special rings and clamps (Filshi clips, Hulk-Wulf spring clamps). Mechanical devices are applied to the tubes, 1–2 cm away from the uterus. The advantage of mechanical methods of sterilization of women is less trauma to tubal tissue, which facilitates reconstructive interventions if it is necessary to restore fertility. As a method of sterilization, coagulation of the fallopian tubes, the introduction of special plugs or chemical agents into them that cause scarring stricture of the tubes are used.

Methodology

Minilaparotomy for sterilization can be performed a month or more after birth; access to the tubes is through a suprapubic incision 3-5 cm long. Minilaparotomy is difficult to perform if the patient is significantly obese or has adhesions in the pelvic cavity. Through minilaparotomy access, sterilization is carried out using the Pomeroy and Parkland methods, Filshi clamps, fallopian rings or spring clamps are also used.

Laparoscopic sterilization is minimally invasive, can be performed under local anesthesia, and short rehabilitation. During laparoscopic sterilization, clamps, rings, and electrocoagulation of tubes are applied. Transvaginal sterilization can be performed by colpotomy using an optical device - a culdoscope, or transcervically by hysteroscopy. Hysteroscopic sterilization allows the introduction of occlusive drugs (methyl cyanoacrylate, quinacrine, etc.) into the fallopian tubes.

In 1% of cases after sterilization operations, complications occur in the form of wound infections, trauma to the intestine, bladder, uterine perforation, and unsuccessful blockage of the fallopian tubes. Reversibility of tubal sterilization is possible; it requires microsurgical intervention and tubal plastic surgery, but is often accompanied by ectopic pregnancies and does not always lead to restoration of fertility.

Cost of sterilization for women in Moscow

Surgical sterilization includes a variety of techniques that create an obstacle to the penetration of sperm into the egg at the level of the fallopian tubes. In the capital, such interventions are carried out in large specialized and multidisciplinary centers and have a fairly affordable cost. The price of sterilization for women in Moscow is influenced by the chosen option for blocking pipes, the need to use chemicals and synthetic implants. The cost of the procedure may vary depending on the qualifications of the specialist and the availability of additional services.

All materials on the site were prepared by specialists in the field of surgery, anatomy and specialized disciplines.
All recommendations are indicative in nature and are not applicable without consulting a doctor.

Author: Averina Olesya Valerievna, candidate of medical sciences, pathologist, teacher of the department of pathological anatomy and pathological physiology

Effective methods of preventing unwanted pregnancy have always been a pressing issue for women. Today there are many ways to prevent conception, but all of them are not without drawbacks, and the likelihood of pregnancy, although scanty, does exist. Tubal ligation is one of the most effective ways to prevent pregnancy, which is performed surgically.

After tubal ligation, the possibility of fertilization and embryo development is completely excluded, therefore the result of the procedure in the form of infertility is considered irreversible. A woman who, for whatever reason, has decided to undergo surgical sterilization is always informed about this.

Indications for tubal ligation are strictly defined, and the patient who wishes to undergo such an operation signs documents confirming her consent and awareness that pregnancy will never occur again.

It happens that after the dressing, after several years, a woman’s life circumstances change, she may get married again, want to have another child, but infertility caused by the operation will not provide such an opportunity, so doctors suggest that you consider your decision very carefully and consult with life partner or close relatives.

As a rule, surgical sterilization is performed when there are medical contraindications for subsequent childbearing, for example, the woman is seriously ill. Much less often, the operation is used solely for the purpose of contraception when the patient is in full health.

Advantages and disadvantages of surgical sterilization

tubal ligation

The fallopian tubes play a transport role for the egg released from the ovary; here it is fertilized and delivered to the uterine cavity for further development of the embryo. The purpose of tubal ligation is to eliminate the possibility of germ cells meeting, so pregnancy will not occur after the operation under any circumstances.

It is believed that it is impossible to become pregnant after surgery, however, isolated cases of spontaneous restoration of tubal patency are known. Probably the reason for this is a violation of the surgical technique or the choice of the wrong method of manipulation. It is also possible to restore the patency of the pipes with the help of various plastic surgeries, which are very complex and do not guarantee a positive result.

If a woman wants to give birth to a child after the dressing, then most likely she will have to contact reproductive specialists who can offer the method of in vitro fertilization (IVF). This method of childbirth also does not always give a 100% result, it is complex, expensive and often difficult both physically and emotionally for a potential future mother, therefore, in the case when a woman cannot be completely sure that there will be no desire to have a child , it is better to refuse bandaging.

Tubal ligation is an operation that, like any other radical effect, is not without pros and cons. Of course, the complete elimination of the possibility of pregnancy can be considered an undoubted advantage, but the disadvantages should not be ignored.

Among advantages of the method Compared to other methods of preventing pregnancy indicate:

• Zero chance of pregnancy in the future;
• No effect on hormonal levels, general condition and libido;
• Possibility of dressing after caesarean section.

The disadvantages of tubal ligation are:

1. Possibility of complications after surgery - bleeding, inflammation, etc.;
2. Irreversible infertility;
3. Risk of ectopic pregnancy if surgical technique is violated;
4. The need for anesthesia.

It is not difficult to notice that experts consider the complete absence of the possibility of getting pregnant in the future to be both an advantage and a disadvantage of the method. This is understandable, because the main goal - sterilization - is successfully achieved, but there is almost never a complete guarantee that a woman will not regret her decision. Moreover, statistics show that more than half of the patients wanted to restore their fertility in the future.

An important advantage of surgical sterilization is the absence of its influence on hormonal levels. The intersection of the tube does not affect the functioning of the ovaries, hormones are released in the right quantities according to the woman’s age, and the menstrual cycle does not change.

Indications and contraindications for tubal ligation

Indications for surgical sterilization are:

• A woman’s reluctance to have children in the future if she already has at least one child and is over 35 years old;
• Medical reasons that make pregnancy and childbirth dangerous to the health and life of a woman are severe pathologies of the heart, lungs, kidneys, malignant tumors, genetic abnormalities that will be inherited by offspring, decompensated diabetes mellitus, etc.

In both cases, the woman’s written desire to undergo tubal ligation is necessary; consent to the operation must be signed by the woman herself and certified by specialists, but if the presence of children is taken into account in the voluntary desire to ligate the tubes, then if there are medical contraindications to pregnancy and childbirth, ligation can be performed even in their absence.

Surgical sterilization of women with severe mental pathology is possible, but the patient is declared incompetent, and the decision to ligate the tubes is made by the court.

Among the contraindications to surgical contraception– inflammatory processes in the pelvis, high degree of obesity, tumors of the genital organs and intestines, strong adhesions in the pelvic cavity. The operation may be impossible due to general severe diseases of the internal organs, making anesthesia and surgery very risky.

Preparation for surgery and technique for performing it

At the stage of preparation for tubal ligation surgery, a woman must undergo a number of examinations:

These diagnostic procedures can be completed in your clinic before hospitalization, but some of them (coagulogram, gynecological examination and smear) can be repeated immediately before surgery. According to indications, an ultrasound scan of the pelvic organs is performed; in all cases, the possibility of intrauterine pregnancy has already occurred is excluded.

At any time during the preparatory period, a woman can refuse the planned intervention if for any reason she changes her mind. At this stage, she has to repeatedly answer the question about her absolute confidence in the need for sterilization, so cases of refusals to ligate tubes do occur.

The tubal ligation operation lasts on average about half an hour, is performed under general anesthesia, spinal anesthesia is acceptable when the patient is conscious during the intervention. For tubal manipulation, laparoscopic access, minilaparotomy, and open laparotomy are usually used. In more rare cases, hysteroscopic and colpotomy approaches are used.

The intervention technique and anesthesia depend on the woman’s condition, the qualifications of the personnel, and the availability of appropriate equipment for minimally invasive operations.

Before the intervention in the evening, a cleansing enema is performed to empty the intestines and prevent some unpleasant consequences after anesthesia and pneumoperitoneum. The gynecologist and anesthesiologist talk with the patient. The last meal is in the evening; if you have severe anxiety at night, sedatives or sleeping pills may be prescribed.

Laparoscopy

Laparoscopic tubal ligation is the most popular surgical technique. Its advantages are considered to be a short rehabilitation period, the possibility of local anesthesia and on an outpatient basis, and the absence of significant and noticeable scars on the skin.

laparoscopic tubal ligation

During laparoscopy, instruments, a camera and a light guide are inserted through small holes in the abdominal wall, and the abdominal cavity is filled with carbon dioxide to improve visibility. When the surgeon, after examining the internal genital organs, reaches the tubes, then disruption of their patency can be achieved by electro- or photocoagulation, laser evaporation. These methods, as the main risk, have the likelihood of damage to surrounding tissues by high temperature, in order to prevent which, the abdominal cavity is filled with a sufficient volume of gas and washed with saline solution for cooling. Mechanical obstruction of tubal patency during laparoscopy is carried out using special rings, clips, and staples.

Minilaparotomy

Minilaparotomy is a fairly simple way to access the tubes and ligate them; it does not require expensive and complex operating room equipment and a very highly qualified gynecologist. With a minilaparotomy, a small incision is made about 3 cm above the symphysis pubis, through which the doctor opens the way to the pelvic organs, examines them, finds the pipes and disrupts their patency mechanically or by another method.

minilaparotomy

The advantages and disadvantages are similar to those of the laparoscopic approach, but this type of surgery is preferred after delivery. It is not advisable to use it for uterine fibroids or severe obesity. Minilaparotomy is considered an excellent alternative to laparoscopic surgery in the absence of appropriate equipment and a trained surgeon.

Laparotomy

During laparotomy, the abdominal cavity is opened through a suprapubic or midline incision. This method of operation can be used for caesarean section, after which tubal ligation is also possible.

Hysteroscopic and colpotomy approaches

In the presence of hysteroscopic equipment, disruption of the patency of the fallopian tubes can be carried out directly by influencing the inner layer of the tube. The basis is usually coagulation, that is, thermal damage to the mucous membrane. Hysteroscopic sterilization does not require abdominal incisions; the equipment is inserted through the vagina into the uterine cavity, then to the tubes.

With colpotome access, the pelvic cavity is entered through the vagina, making an incision in its posterior wall and penetrating through the tissue between the vagina and rectum. The tube is pulled into the wound, bandaged, and then the tissue is sutured. The advantage of access is relative simplicity, accessibility and low cost, the absence of skin incisions and sutures; among the most significant disadvantages is the likelihood of infection.

To obstruct the patency of the fallopian tubes during the above interventions, the following can be used:

• Bandaging with suture material with excision of a fragment of the pipe;
• Rings and clamps are less traumatic and provide a greater chance of restoring reproductive function through plastic surgery;
• Coagulation by electric current, laser, ultraviolet.

The surgical sterilization operation can be performed at different times - in the absence of pregnancy in the second phase of the cycle, after a medical abortion, six weeks after delivery or during a cesarean section. After a natural birth, tubal ligation is possible within the first two days or after three days to a week.

Postoperative period and complications

The postoperative period does not have any significant differences from that of other operations. If the tubes were tied during colpo- or hysteroscopy, then the patient can leave the clinic after 24 hours; after laparoscopy, observation is required for 2-3 days. The postoperative period for laparotomy takes 7-10 days, after which the sutures are removed.

Surgical sterilization requires physical rest for a week, and for the same period it is necessary to abstain from sexual activity. For the first few days, water treatments are highly discouraged.

Tubal ligation surgery is considered safe regardless of the method used. However, in rare cases there are complications. During the intervention, there is a risk of bleeding and damage to other abdominal organs, especially during coagulation of the tubes. If the surgical technique is not followed, the risk of infection and inflammation in the pelvic organs increases. Allergic reactions to anesthesia medications are very rare. Long-term consequences include possible, although unlikely, menstrual irregularities, bleeding, and tubal pregnancy.

For tubal ligation during cesarean section, the consequences are similar to those outside labor. Sterilization does not in any way affect the hormonal function, milk production or feeding of the baby. Sexual behavior and the general well-being of the mother do not change, but due to low awareness and lack of clearly defined indications for postpartum women, surgical tubal ligation in this category of women is performed quite rarely.

Tubal ligation surgery in public hospitals is carried out free of charge under the compulsory medical insurance system. The state bears the costs. If desired, it is possible to undergo paid treatment in private clinics or even in public ones, but with the right to choose more comfortable conditions for staying in a hospital.

The cost of tubal ligation ranges between 7-9 and 50 thousand rubles. The price includes payment for the operation itself, consumables and medications, examinations, stay in the ward, food, etc.

A little history

The ancient Egyptians practiced surgical sterilization of women, which involved destroying ovarian tissue using a thin wooden needle. In the East, sterilization of eunuchs - caretakers of the sultans' harems - has long been used. And in later times, there were sects that used the sterilization of women and men for various purposes.

Excursion into physiology

The uterus is a hollow, pear-shaped muscular organ. The fallopian tubes extend from the lateral surfaces of the uterine fundus. The other end of each tube is adjacent to the ovary. The body of the uterus has a triangular outline, gradually tapering towards the cervix. Thus, the uterine cavity has the shape of a triangle with the apex facing downwards. The cervical canal approaches the top of this triangle from below, and the fallopian tubes adjoin the area of ​​the corners located in the upper part of the triangle.

Sperm from the vagina enter the cervical canal, then into the uterine cavity, and after that into the fallopian tubes. It is in the fallopian tube that fertilization of the egg by the sperm occurs. After fertilization, the embryo, thanks to contractions of the fallopian tube, moves back into the uterus, where it attaches to its wall. There the fetus develops until the moment of birth.

How to carry out sterilization

The essence of the female sterilization operation is that the patency of the fallopian tubes is disrupted by various methods.

Previously, for sterilization, an incision was made in the abdominal cavity, during which the surgeon found the fallopian tubes. Then they were bandaged. And then the fallopian tubes were cut between the two threads. This technique was quite simple and reliable; spontaneous restoration of patency (recanalization) occurred extremely rarely. The success rate of the method was 99.5% and above, i.e. The patency of the fallopian tubes, depending on the technique, was restored on average in 2 cases per 1000 operations, i.e. in 0.2% of patients.

However, this method had a significant drawback: the operation required opening the abdominal cavity, so most often they were performed not independently, but as the second stage of any abdominal operation - cesarean section, etc. After all, you must admit, not every woman will decide to undergo abdominal surgery for such a purpose.

Currently, such operations are performed laparoscopically: through 3 small punctures, a miniature video camera and special small-sized endoscopic instruments are inserted into the abdominal cavity. Surgical sterilization is carried out in a gynecological hospital.

There are two main methods of laparoscopic sterilization: electrocoagulation (cauterization) and mechanical occlusion of the fallopian tubes.

In the first case, the pipe is cut with an electrocoagulator or grabbed with electric tweezers so that the pipe walls stick together under the influence of current and become impassable.

In the second method, mechanical sterilization is performed according to the following method: A ring is placed on the outside of the fallopian tube or, at a distance of 2-3 cm from the angle of the uterus, two clips are applied. The pipe between them is crossed. Clipping without intersection is less reliable, since it is possible to cut through the clip and recanalize the pipe. The duration of the operation, depending on the methods and technique, ranges from 10 to 20-30 minutes. Contraindications are extensive adhesions of the abdominal cavity and pelvis, which complicate the operation, and the presence of large fat deposits, which can also interfere with laparoscopy.

After operation

A complication of anesthesia can be aspiration (entry into the respiratory tract) of vomit. Complications such as injuries to the abdominal and pelvic organs during surgery, inflammatory complications after surgery, and adhesions are rare.

The patient is allowed to get up at the end of the first day, and then feeding begins. Drug therapy is not prescribed for normal progression. The hospital period after surgery lasts 1-3 days.

Sterilization as a method of contraception is highly reliable. However, it is necessary to understand that sterilization is a conditionally irreversible process.

One more important point should be noted. Many people confuse sterilization with castration - an operation in which the function of the ovaries is “turned off” in one way or another and the production of sex hormones is disrupted. This does not happen during sterilization.

If the operation was successful, then there should be no additional changes in the body, except for the lack of the ability to conceive.

What does the law say?

The law clearly defines the conditions under which sterilization can be carried out. Let us turn to the “Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens”, adopted on July 22, 1993, section VII (“Medical activities for family planning and regulation of human reproductive function”). Article 37 of this law states: “Medical sterilization as a special intervention with the aim of depriving a person of the ability to reproduce offspring or as a method of contraception can be carried out only upon the written application of a citizen who is at least 35 years old or has at least two children, and in the presence of medical indications and consent citizen - regardless of age and presence of children. The list of medical indications for medical sterilization is determined by the Ministry of Health of the Russian Federation.”

Indications for sterilization are listed in the order and include 55 diseases. These indications are established by a commission consisting of at least 3 specialists: an obstetrician-gynecologist, a doctor of the specialty in which the patient’s disease relates, and the head of a health care institution. Medical sterilization of persons declared incompetent and suffering from mental illness is carried out only on the basis of a court decision. The patient must understand that restoration of tubal patency after any method of sterilization cannot be guaranteed. Therefore, before deciding to undergo this operation, a woman should clearly determine for herself that she does not want to give birth again.

However, the irreversibility of fertility restoration is relative. If a woman suddenly wants to have children again, it is possible to perform so-called tubal plastic surgery - restoring their integrity and patency using a special technique. The successful recovery rate is 60-80%.

In addition to reconstructive operations, in vitro fertilization is available to women. In this case, first an egg is removed from the ovary, and then an embryo is inserted into the uterine cavity. In this case, patent fallopian tubes will not be an obstacle to pregnancy.

Advantages and disadvantages

The sterilization method, naturally, has both advantages and disadvantages.

The disadvantages include the above-mentioned relative irreversibility of the procedure. But this method has many advantages. One of them is that a single procedure relieves a woman of the problems of contraception, and for many women after 35 this is a serious problem. Children are no longer small, I want to live a full life, but there are already serious restrictions in terms of using, for example, hormonal contraceptives or intrauterine devices. Indeed, by this time, a woman often accumulates a whole “bouquet” of diseases, including thrombophlebitis and chronic diseases of the pelvic organs. And for many, sterilization is an opportunity to be sexually active without fear of unwanted pregnancy.

New methods

Recently, a new, simpler and safer method of sterilizing women has been developed, which does not require surgery or entry into the abdominal cavity. Its essence is that various drugs or devices introduced into the uterus cause, for example, local tissue damage with an inflammatory reaction. The site of injury grows with connective tissue, and the fallopian tubes are blocked.

For example, the development of the Australian company Conceptus called Essure is a microspiral with a special thread. These are microinserts that are inserted into the fallopian tubes and disrupt their patency.

Essure is administered without abdominal surgery, under local anesthesia. A hysteroscope, a type of endoscope designed to work in the uterine cavity, is inserted into the uterus through the vagina. Under visual control, a microliner is inserted into each fallopian tube.

Over time, connective tissue grows through them, so that the fallopian tubes become impassable for sperm, and, accordingly, fertilization does not occur.

It takes 15 minutes to process each fallopian tube. The patient can go home on the same day.

Large-scale studies have shown that the effectiveness of this method is more than 99%. 92% of women return to their usual activities within one day or less, although they have to see the doctor again after three months.

It takes about three months for the device to grow with connective tissue and completely block the fallopian tube, after which a control X-ray is taken, and, if necessary, an X-ray with a contrast agent. With such a study, it is possible to make an accurate conclusion about the patency of the tubes, since it turned out that in 2.5% of cases protection is not enough and the fallopian tubes partially retain patency.

However, given the simplicity and safety of the operation, it can be assumed that it has good prospects.

Arzy Umerova

Now there are quite a few methods of contraception. One of these is female sterilization.

The essence of the method is to disrupt the patency of the fallopian tubes, because it is in this place that the sperm fertilizes the egg.

Sterilization methods

Previously, the operation was performed through an abdominal incision. In this case, the fallopian tubes were ligated and cut between the threads. This method was highly effective, since recanalization (recovery) occurred quite rarely. A significant disadvantage was the large incision, so sterilization was mainly carried out during other operations, for example, after a caesarean section.

Nowadays, most of this operation is performed using laparoscopy: 3 small punctures are made in the abdominal cavity, a miniature video camera and small endoscopic instruments are inserted inside. This type of surgery is performed in a gynecological hospital.

Laparoscopic sterilization surgery for women is performed using two methods: mechanical blockage of tubes and electrocoagulation (cauterization).

The first option involves placing a ring or two clips on the fallopian tube and cutting it. Clipping itself is a less reliable option, since the clip may cut through and the pipe will be restored. The operation, depending on the method and technique, lasts 10-30 minutes.

In the second case, the pipe is cut off with an electrocoagulator or electric tweezers. As a result, its walls stick together under the influence of current.

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

A mini-laparotomy involves making a puncture in the pubic area, no smaller than 5 cm in size.

Surgical tubal ligation may be performed in the following cases:

• When performing another abdominal operation;
• For inflammatory pathologies of the pelvic organs;
• For endometriosis;
• In parallel with operations on the abdominal cavity or pelvic area.

Abdominal surgery leaves a scar, laparoscopy leaves small scars that will be invisible in the future, culdoscopy leaves no traces.

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

Absolute contraindications

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

Among them:

• Pregnancy;
• Acute gynecological inflammatory diseases;
• Active sexually transmitted diseases (treatment before surgery);
• Significant adhesions of the abdominal cavity and pelvis, which complicate surgical intervention;
• The presence of significant fat deposits;
• Umbilical hernia;
• Blood clotting disorder;
• Diabetes;
• Chronic diseases of the lungs and heart.

When performing laparoscopy, pressure is created in the abdominal cavity and it is necessary to tilt the head down. Such actions may obstruct 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 the problems of contraception once and for all, this is especially important for women over 35 who want to have a full sex life, but are limited in taking hormonal contraceptives and 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 people are interested in whether sterilization affects hormonal levels. We can definitely answer that no malfunction will occur, because the fallopian tubes do not produce hormones. The ovaries do this.

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

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

This procedure is a one-time procedure, so there are no post-operative costs. There is no need to buy condoms or birth control pills.

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 and do not have the opportunity to use other methods if there is a risk of transmitting a hereditary disease to a future child.

It is not recommended to use this method for women under 30 years of age who do not have children, who have had problems with pregnancy, without a permanent relationship, at the whim of a sexual partner. It is worth considering that the consequences may be irreversible even with a strong desire to restore reproductive function.

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

Consequences of sterilization for women

The operation is performed only with the voluntary consent of the patient. Since the event leads to the elimination of reproductive 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 will definitely be told that:

• There are other ways to protect against unwanted pregnancy, for example, male sterilization is a less dangerous procedure;
• Tubal suppression is a surgical intervention, that is, a full-fledged operation with all possible consequences, including the postoperative period. Hematomas may occur, which will eventually resolve, but will cause discomfort at first. During the procedure, there is a risk of damage to internal organs if the method of intervention through the abdominal cavity is chosen;
• After a successful operation, a woman will not be able to become pregnant naturally. About 3% of patients wish to regain reproductive function. Although modern surgery makes it possible to do this, 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 consider this option. Fertilization is explained by several factors: the development of a uteroperitoneal fistula after electrocoagulation, inadequate occlusion or recanalization of the tubes.

After sterilization

In the postoperative period, physical activity is completely excluded for 2 weeks. In the first two days you should not take a shower or bath. To prevent swelling at the incision site, bleeding and pain, compresses are used.

Sterilization of women is considered the most effective method of birth control, but at the same time the most dangerous.

Definition

Female sterilization involves creating an artificial obstruction of the fallopian tubes by cutting them, tying them, or removing parts of them. When carrying out such an operation, due to the resulting barriers, the eggs cannot meet sperm on their way. Despite this, pregnancy still occurs in 3% of 100 cases. Why this happens is still not clear. Now, during the rapid development of medicine, hospitalization for such an operation is not required; the procedure is performed in medical clinics under general or local anesthesia. After female sterilization, no obvious changes occur in the body: sexual desire remains at the same level, the menstrual cycle occurs according to the deadline.

Sterilization of women: types

In medical practice, there are several types of operations to sterilize women.

1. Ligation of the fallopian tubes, the essence of which is to remove a fragment of the fallopian tubes. For these purposes, 5 cm long incisions are made in the left or right side of the abdomen. Rehabilitation is 36-48 hours.

2. Laparoscopy - sterilization using punctures in the abdominal cavity. There are three types of laparoscopic sterilization:

1) tubal ligation - the tube is tied into a loop and secured with a self-absorbing clamp;

2) cauterization of the fallopian tubes - the tubes are affected by an electric current of medium voltage, resulting in the formation of scars that impede the movement of sperm and eggs;

3) pinching of the fallopian tubes - blocking the tubes using special clothespins; The advantage of this method is that the clothespins can be removed and reproductive function can be restored.

3. This method of sterilization, such as hysterectomy (complete removal of the uterus), has long been a thing of the past. Such operations are performed very rarely and only when it is necessary to save a woman’s life.

Female sterilization: benefits

1) highly effective method of contraception;

2) suitable for women who are contraindicated to use other methods of protection against unwanted pregnancy;

3) short period of postoperative rehabilitation;

4) no effect on hormone levels, libido and menstrual cycle.

Sterilization of women: cons

Despite the presence of significant advantages, such operations have a number of negative features:

1) general anesthesia, which has a negative effect not only on the entire body as a whole, but also increases the recovery period;

2) lack of protection from sexually transmitted diseases;

3) inability to get pregnant and give birth again;

4) there remains a low probability of becoming pregnant.

Female sterilization: consequences

For a long time after the operation, the woman feels discomfort and a feeling of bruising;

Sutures are removed a week after surgery;

Formation of hematomas at the surgical site, which do not always resolve on their own;

When pregnancy occurs, the egg cannot reach the uterus and begins to grow in the tube, which leads to an ectopic pregnancy, which puts the woman’s life at risk.