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Sunday, 8 December 2013

Contraception - Female Sterilization

Female Sterilization is a type of surgical or non surgical pregnancy prevention to block the sperm from fertilizing the egg and carrying it to the uterus as the Fallopian of the woman is cut through or blocked. Female sterilization is considered permanent. It had been one of the popular methods of choice of birth control in the later part of 20 century, but, today, female sterilization is become less popular due to some newly discovered side effects, such as higher incidence of pelvic pain, increased risk of period problems, risk of ectopic pregnancy, etc.

Types of female sterilization
There are 2 types of female sterilization
A.. Tubal ligation
1. In tubal ligation, the Fallopian tube of a woman are cut and sealed by burning from a electrical needle or closed with clips or rings. Normally, it is done at the hospital with general anesthesia with an incision of each side just below the navel to gain access to each of the 2 fallopian tubes.

2. The advantages of tubal ligation
a. Reduced risk of ovarian cancer.
b. Very effective in protection against unexpected pregnancy
c.. No hormonal change
d. Less side effects than oral contraceptive methods.
e. Etc.

3. The disadvantages of tubal ligation
a. Increased risk of postoperative complications.
b. Risk of mortality is 4 per 100,000
c. Risk of post-tubal sterilization syndrome, such as bleeding, pain, changes in sexual behavior, etc.
d. Risk of pre-existing histories of menstrual dysfunction may be increased.
e. It is costly in a short term
f. No protection against sexual transmitting diseases.
g. It is permanent and may not be reversed. reversal of tubal ligation has provided only 60-80%
of a successful pregnancy.
h. Etc.

B. Hysteroscopic sterilization
1. Hysterscopic sterilization, also known as the Essure procedure is a nonsurgical form of permanent sterilization performed under local anesthesia in which a physician implants a small ring-like coil into each one of a woman's two fallopian tubes through the vagina. Overtime, scar tissue grows around the inserted coils and blocks the tubes.

2. The advantage of hysteroscopic sterilization
a. No surgical cut or incision.
b. Local anesthesia
c. Cost and time effective as it can be performed in the doctor office
d. In study of Pain Associated With Hysteroscopic Sterilization by Radha Syed, MD,corresponding author Jenna Levy, MD, and Meredith E. Childers, MA, researchers found that Hysteroscopic sterilization offers a minimally invasive, less painful, equally efficacious modality for sterilization than laparoscopic sterilization and should be available to all women seeking permanent birth control.
e. Do not cause hormonal change
f. Etc.

3. The disadvantage of hysteroscopic sterilization
a. Risk of unilateral tubal occlusion
b. Time is required to confirm the tubal occlusion. Sometime it takes as long as over 12 weeks.
c. High cost of tubal occlusion confirmation.
d. Interference with the uses of electrocautery in future abdominal surgery due to coil implanted.
e. Increased risk of infection.
f. Hypersensitivity to nickel
g. Do not protect against sexual transmitting diseases if compared to oral contraception.
h. Etc.
Sources