Key Facts about sterilisation

Sterilisation is a permanent form of contraception which involves an operation to stop the sperm and egg meeting. Tubal ligation is the permanent contraception for women and vasectomy is the permanent contraception for men. You will need to visit your doctor or a specialist to discuss sterilisation.

Tubal ligation (female sterilisation)

It involves a small operation in which a woman’s fallopian tubes are cut or blocked; this stops sperm from reaching an egg to fertilise it.

• Tubal ligation is a permanent form of contraception that should only be considered when you are sure that you do not want to have a child in the future.
• It is a very reliable and in most cases will prevent pregnancy but it is not 100% effective. About 1 in 200 women who have a tubal ligation may become pregnant.
• Tubal ligation may be performed under general anaesthetic either by a simple laproscopic procedure that takes about 30 minutes or a more complex surgical procedure that will require a stay in hospital for one or two days.
• Having a tubal ligation does not affect your sexuality or sex drive.
• Tubal ligation does not protect against STIs.

Vasectomy (male sterilisation)

It involves a small operation performed in males, in which a tube (called vas deferens) within each testicle is clamped, cut or sealed. This prevents the release of sperm during ejaculation.

• Vasectomy is a permanent form of contraception that should only be considered when you are sure that you do not want to have a child in the future.
• It is very reliable and in most cases, will prevent pregnancy, but it is not quite 100% effective. About 1 in 2,000 men who have had a vasectomy will become fertile again at some point in the future.
• Vasectomy is a simple operation which takes about 15 minutes. It can be done at a doctor’s surgery or a hospital.
• Having a vasectomy does not affect your sexuality or sex drive.
• Vasectomy does not protect against STIs.

Where to get it

You will need to visit your doctor or a specialist to find out more about the options for tubal ligation and vasectomy. 

Tubal ligation

Tubal ligation is a permanent form of contraception, to prevent pregnancy. It involves a small operation in which a woman’s fallopian tubes are cut or blocked; this stops sperm from reaching an egg to fertilise it.

Laparoscopic tubal ligation

This is the most common procedure by which tubal ligation is performed. In this procedure:

• Two small incisions are made in the abdomen. A laparoscope (a long thin tube with a camera and light source at its tip) is inserted through one incision and surgical instruments are inserted through the other incision.
• The fallopian tubes are then able to be located and the tubal ligation performed.
• The incisions in the abdomen are closed with steristrips (small paper tapes) or small stitches.
• Laparoscopic tubal ligation is usually performed under a general anaesthetic.
• The procedure takes approximately 30 minutes and won’t normally require an overnight stay in hospital.

Mini-laparotomy

Sometimes an “open” surgical approach known as mini-laparotomy may be required if the laparoscopic approach is unsuitable such as:

• if there is scarring in the pelvis from previous surgery
  medical conditions such as endometriosis.

With this approach:

• A single incision approximately 4 to 5 cm long is made, just above the pubic hair line.
• The fallopian tubes are located and the tubal ligation performed.
• The incision is closed with dissolvable stitches.
• This type of tubal ligation usually requires a hospital stay of one to two days.

Vasectomy

Vasectomy is a simple operation, which takes about 15 minutes. It can be done at a a doctor’s surgery or a hospital. It is usually done under a local anaesthetic. This means you are awake but have an injection into the skin so that you do not feel pain. Sometimes vasectomy is done under a general anaesthetic.

In no-scalpel vasectomy:

• Local anaesthetic is injected into a small area of skin on either side of the scrotum above the testicles (testes).
• The doctor feels the tubes under the skin and holds them in place with a small clamp.
• They then make one tiny puncture with a special instrument. The same instrument is used to gently stretch the opening so the tubes can be reached.
• The tube is brought to the surface through the small opening. Different doctors use different techniques, but all are designed to ensure the two ends of the cut tubes remain separate.
• The second tube is treated in the same way through the same hole. There is very little bleeding with this technique.
• No stitches are needed to close the opening, which heals quickly without leaving a scar.

Tubal Ligation (female sterilisation)

Pros

• You do not have to remember to take a pill every day.
• After the procedure is complete, it is a private form of birth control.
• Tubal ligation does not interfere with intercourse.
• There are no significant long-term side effects.

Cons

• As tubal ligation is permanent, and difficult to reverse, some people regret having it – especially if their circumstances change.
• Tubal ligation does not protect against STIs. Condoms are the most effective method for preventing STIs.
• There are possible short-term surgery-related complications such as discomfort, infection, bruising or bleeding at the operation site, and possible reaction to anesthesia.
• You will need to see a doctor or specialist.

Vasectomy (male sterilisation)

Pros

• Vasectomy is a safer, cheaper procedure that causes fewer complications than tubal ligation in women (female sterilisation).
• Vasectomy is a permanent method of birth control. Once your semen does not contain sperm, you do not need to worry about using other birth control methods.
• Although vasectomy is expensive, it is a one-time cost. The cost of other methods, such as birth control pills or condoms and spermicide, is likely to be greater over time.

Cons

• The effect of a vasectomy in preventing pregnancy is not immediate; it may take a few months before the semen is free from sperm.
• As a vasectomy is permanent, some people regret having a vasectomy, especially if their circumstances change.
• A vasectomy does not protect against STIs. Condoms are the most effective method for preventing STIs.
• You will need to see a doctor or specialist.

Where to get tubal ligation (female sterilisation)?

You will need to see your doctor or a specialist (gynaecologist) to find out more about tubal ligation and what services are available in your area. 

What complications are there with tubal ligation?

For the most part tubal ligation is a safe procedure with very few complications. Most women have no problems after a tubal ligation, however their is a small risk of:

• Infection, bruising or bleeding at the operation site.
• Pelvic pain or pain in the abdomen.
• A possible reaction to anesthesia.
• Rarely, damage to organs, including the bowel, bladder, uterus, ovaries, blood vessels and nerves can occur.

Where to get a vasectomy (male sterilisation)?

You will need to see your doctor or a specialist (urologist) to find out more about vasectomy and what services are available in your area. 

What complications are there with vasectomy?

For the most part, vasectomy is a safe procedure with very few complications. Most men have no problems after a vasectomy, however:

• There is a small risk of a wound infection after the surgery.
• Bruising around the operation site may occur but it will go in a week or so.
• Sometimes sperm may leak into the scrotum and form a swelling which may need treatment.
• You may experience a dull ache in the scrotum for a few weeks or months after the operation. This usually settles within three months.