Sterilization from pregnancy. What is female sterilization? Facts about female sterilization

Very often, women who go for repeated C-section, doctors suggest sterilization. This is one of the methods of voluntary surgical contraception, briefly called VHS (voluntary surgical sterilization), which today guarantees the highest, almost 100% degree of protection against unwanted pregnancy .

Sterilization of women is very popular in the West and is finding more and more supporters in our country. The essence of the method is that the sperm is stopped, the path to the egg, which it must pass through the fallopian tubes, is blocked, therefore, fertilization does not occur.

About, At what age is female sterilization allowed? how this operation is performed, whether it is reversible, what reviews it has from those who have had it done, how it affects health and whether sterilization affects sexual desire - we’ll talk today on the women’s website “Beautiful and Successful”.

Who can be sterilized?

An interesting fact is that different countries have different approaches to solving the question of at what age can a woman be sterilized?

So, in Belarus and Ukraine this procedure allowed for women (by the way, citizens of the state and guests) from 18 years old, regardless of the number of children, in Sweden - from 25, but in Russia there are some nuances.

In Chapter 6, Article 57 Federal Law Russia “On the basics of protecting the health of citizens in Russian Federation", which came into force on January 1, 2012 indicated, who can undergo sterilization?

  • This procedure, as a method of contraception, is carried out for both men and women with their written application, if their age is over 35 years or for those citizens who already have two or more children.
  • In cases medical indications (compiled by them separate list) sterilization is carried out regardless of the age or number of children.
  • Illegal sterilization entails criminal liability.

In our country, in 50% of cases, sterilization is carried out immediately after childbirth, if it was by caesarean section.

It should be noted once again that in Russia women are sterilized only by voluntary consent women, with her written statement and preliminary consultation, during which they explain what female sterilization is, the pros and cons of this method.

A woman may be refused sterilization if she has There is medical contraindications, which include:

How is DHS carried out?

If a woman is sterilized not after a caesarean section (in this case there is already Free access to the fallopian tubes), and as planned, they are “selected” to the site of the operation in several ways, resorting to the following technologies:

  • regular surgery – “the old fashioned way”, when an incision is made in the suprapubic region. Nowadays this method is rarely practiced.
  • laparoscopic surgery- punctures are made in abdominal area, through which sterilization is carried out. This is the most common method today.
  • culdoscopic surgery– through the vagina.

Each type has its own consequences: after normal operation a scar remains, with laparoscopy - barely noticeable scars from punctures, which become invisible over time, with culdoscopy - there are no traces.

Sterilization of women is carried out under general or local anesthesia outpatient, depending on the chosen method.

After getting inside, the sterilization procedure is carried out directly. It is done in several ways:

  • dressing fallopian tubes - ligation,
  • pinch And dissection (excision) a certain section of the fallopian tubes by pinching with special rings, clamps, forceps, clips with further separation of the ends of the fallopian tubes.
  • coagulation method - "soldering" section of the pipe using a laser or electrosurgical instrument.

So the operations are different by operating method And according to the method of dividing the fallopian tubes. We will not go into details of each method. Let us note only one thing: most often today sterilization is carried out using laparoscopy by cutting the fallopian tubes– this method of DHS is considered the most reliable.

Sterilization of women can be combined with a caesarean operation, as we have already said, or it can be carried out in the second phase of the menstrual cycle. After natural birth This operation can be done after 2 months.

What changes after sterilization?

What difference does sterilizing women make? The consequences are psychological and physiological in nature.

Sometimes reviews about sterilization say that women cannot cope with the feeling of emptiness and They even consider themselves to some extent inferior.

  • “My husband insisted on sterilization. We already have 2 children, he said that we need to at least get these on their feet. He is against abortion, and the pills don't work for me. Other methods were not considered. After the operation I feel like something empty inside. It’s hard to accept the fact that I will no longer be able to have children - NEVER!”
  • “I was sterilized using laparoscopy. The first days I felt a little sick inside, there was a dry mouth, and there was some kind of feeling of spiritual emptiness. The neighbors in the ward especially added fuel to the fire, who told all sorts of horrors about how both those acquaintances and others had children who died, and they could not give birth to more. But literally a week later my mood returned to normal, my husband was very supportive. He said that if we really want more children, we can adopt. I am pleased."

Many people are interested in how female sterilization affects hormonal background? In particular, can early menopause occur or some disruptions in the menstrual cycle occur? The answer from the experts is clear: “No. Sterilization cannot cause any problems in the hormonal system."

This operation is aimed at interfering with the functioning of the fallopian tubes, but they do not produce hormones. This function is performed by the ovaries. Interference with the functioning of the ovaries causes hormonal changes.

After sterilization ovulation persists, menstruation occurs, PMS does not disappear anywhere. In addition to all this, a woman retains the ability to artificial insemination, because eggs continue to be released.

Sterilization of women: consequences

Considering that sterilization of women is carried out by voluntary consent and is actually irreversible method for restoring reproductive function, Particular importance is given to counseling, during which the client is told in detail what female sterilization is, the pros and cons this method contraception. Objective information is aimed at helping you make the right and informed decision.

The woman must be informed that:

  • Can be picked up other methods of contraception, including male sterilization, a less dangerous procedure.
  • Sterilization is carried out through surgery and is considered an operation with everyone possible consequences postoperative period. Inside, a woman may feel a bruise, sometimes hematomas appear, which resolve. Also, during the operation, there is a risk of touching and damaging internal organs if sterilization is carried out as a regular surgical operation.
  • If sterilization is successful, the woman will not be able to conceive a child naturally . Restoration of fertility function is virtually zero. Approximately 3% of women who have had sterilization wish to regain their ability to conceive in the future. The reasons for this are different: repeated successful marriage, change social status and, unfortunately, the death of the child is not excluded. Although modern advances in the field of microsurgery make it possible to allow the reversibility of this operation, this is very difficult and complex process which does not always lead to the desired result. The success of the reverse procedure depends on the technique of sterilization, the time that has passed since it was carried out and other factors.
  • After sterilization there is risk of occurrence ectopic pregnancy.

Women's site site draws Special attention what a woman can do from sterilization refuse at any time.

Cost of the operation

Sterilization is considered an expensive procedure, but it does not require costs for future protection, like other methods of contraception - this is its advantageous difference. How much does it cost to sterilize women: the price primarily depends on the method of the operation, as well as on the country, region, city, clinic, experience of the specialist and many other factors.

In Russia the price ranges from 15,000 to 21,000 rubles and above, in Ukraine – from 1000 hryvnia.

Contraception in our world is very important, because modern woman is not only a mother and housewife, but also a developing personality. Preventing unwanted pregnancy helps preserve sexual relations between partners, but at the same time exclude conception.

There are several ways to prevent unwanted pregnancy, such as using condoms, hormonal contraceptives and insertion fallopian coils. All these methods are temporary contraception; they do not exclude future pregnancy. Another method of preventing pregnancy is tubal occlusion; let’s look at it in more detail.

First of all, you need to understand what sterilization in women is. Medical female sterilization or tubal occlusion is a method of contraception that involves creating an obstruction of the fallopian tubes surgically, this method of contraception is irreversible. Voluntary surgical sterilization of women in gynecology (VS) is used in countries with increased level fertility, as well as at the request of women around the world.

Schematic representation of sterilization in women. Source: ntsanswerkey.com

Voluntary sterilization is indicated for women over 35 years of age who have children and do not plan to have a child in the future, but want to be active sex life. DHS is also recommended if, due to age, a woman cannot use hormonal contraceptives or a uterine device, then sterilization becomes an alternative. The procedure is recommended for patients with severe hereditary diseases, at which birth healthy child almost impossible.

There is such a thing as forced sterilization of women. This procedure is currently prohibited as it violates human rights. But a few years ago in China, a company was carried out in which forced sterilization of citizens who violated state program family planning. Also, the procedure is still carried out illegally even in Russia in some psychiatric clinics, for which doctors are held accountable.

Advantages and disadvantages

Before going for sterilization, you need to study the pros and cons and learn about the consequences of the procedure. Let's look at the pros and cons of female sterilization.

Advantages:

  • female sterilization allows you to get rid of problems with contraception forever, you do not need to constantly buy pills, condoms or other contraceptives;
  • the risk of inflammation of the appendages is reduced, since occlusion of the tubes does not allow infection to penetrate;
  • Unlike hormonal uterine devices and pills, the operation will not be able to provoke hormonal imbalance, since the fallopian tubes do not affect hormonal levels in any way;
  • the procedure does not make the woman completely infertile, ovulation remains, if desired, you can undergo IVF and become pregnant;
  • The procedure is carried out once and does not require any repeated costs.

Flaws:

  • Tubal occlusion will not protect against sexually transmitted infections, so sex without condoms is allowed only with a regular and healthy partner, otherwise there is a need to use condoms.
  • Another drawback is the irreversibility of the procedure; a woman will never be able to get pregnant naturally. If you want to have a child, you will have to undergo IVF, and such a procedure is expensive, and the result does not always come the first time.
  • Medical sterilization of women is a surgical operation, after which symptoms may appear. various complications, for example, heart problems due to anesthesia, bleeding and infections in the genital area.

Due to the presence of significant disadvantages, the procedure is not recommended for young women who do not have children. You should not decide on DHS if your partner wants it due to difficulties with contraception. It’s worth remembering that a lot can change in life, so you shouldn’t rush ahead and decide on tubal occlusion if you have any doubts.

Contraindications

Medical female sterilization is an operation that has a number of contraindications:

  • Pregnancy period;
  • Gynecological pathologies in the acute stage;
  • Infectious diseases;
  • Diabetes;
  • Adhesions in the pelvis, in which the procedure is impossible;
  • Umbilical hernia;
  • Pathologies of the cardiovascular system;
  • Pathologies of the respiratory system;
  • Intolerance to anesthesia;
  • Oncology;
  • Problems with the circulatory system.

Before the procedure, a woman must mandatory pass the medical checkup and make sure she is healthy. If you ignore this advice and go for surgery with a bad heart or vascular pathology, you can significantly undermine your health.

Preparation

Before the procedure, the woman must visit a therapist and undergo a medical examination, including antenatal clinic They are prescribed to undergo an ultrasound, smears, blood and urine tests. These diagnostic methods make it possible to assess a woman’s condition and exclude oncology and infectious diseases. If any pathology is found, it will first need to be cured, only then will an operation be performed, or the doctor will select another method of contraception.

If there are no contraindications, then the patient is assigned a day of surgery; it is necessary to prepare for the procedure:

  • 12 hours before surgery you should not eat;
  • the doctor stops some medications that a woman may be taking, so it is very important to report them;
  • You should not drink for a week before surgery alcoholic drinks, it is better to quit smoking;
  • It is necessary to completely exclude pregnancy, so it is better to abstain from sex.

Operation

Let's look at how women are sterilized. First of all, it is worth noting that the operation is performed under anesthesia, so the patient will not feel pain during the procedure.

Previously, sterilization of women was carried out using the classical method. The doctor made a large incision in the lower abdomen, about 20 cm. He performed a manual tubal ligation, after which the incision was sutured. After such an operation, a large scar remained, the stitch took a long time to heal and caused some inconvenience to the woman.

Currently, this method of DHS is used extremely rarely, except during a caesarean section, if the woman does not plan to have any more children. Now the operation is performed using laparoscopy - this is a minimally invasive method in which the doctor performs all manipulations through 3 small holes, no more than 1 cm in size.

The procedure is carried out using a small camera and surgical instruments which are inserted into the holes. After the procedure, there are no visible scars left, the rehabilitation period is quick and painless.

Occlusion of the fallopian tubes is carried out using two methods: either the doctor will install a clip, which will obstruct the fallopian tubes, or will make artificial adhesions using electrocoagulation. The second method is more reliable, since there are cases when the clip flew off and the fallopian tube was restored.

Many people are interested in the question of how to sterilize a woman for free; this is only possible during a caesarean section or other gynecological surgery. In this case, you need to inform the doctor about your decision and the procedure will be carried out. DHS is performed using the laparoscopy method only for a fee; such an operation is not included in the list of services provided under the compulsory medical insurance policy in Russia.

Rehabilitation

After surgery, patients are usually recommended to stay in the hospital for two to three days. In the first 2-3 weeks, it is forbidden to lift weights so that the stitches do not come apart, and a woman can move around within a couple of hours during laparoscopy or a day after a full-fledged operation.

The patient is prohibited from taking a shower for the first three days; subsequently, she must wash carefully so as not to wet the wounds. It is forbidden to take a bath until the stitches have completely healed.

Consequences

Any woman who is thinking about medical sterilization is sure to wonder what she may have Negative consequences and how to prevent them. Since the procedure is a surgical intervention and it is irreversible, a woman in any clinic must have a conversation, where the doctor must warn about possible consequences:

  • impossibility of natural conception, reproductive function after occlusion of the tubes it is very difficult to return;
  • complications after surgery;
  • pain in the first days after the procedure;
  • there is a small risk of ectopic pregnancy.

It is worth noting that this operation is quite serious, so it must be performed by a qualified physician in a hospital setting. Otherwise, infection may occur internal organs infection, bleeding and even death. Therefore, in no case should you agree to an operation at home, or if you are not confident in the professionalism of the surgeon.

About sterilization (video)

Female sterilization - permanent method contraception, forever eliminating the possibility of becoming pregnant and giving birth to a child. Usually it is used by women who have already given birth and no longer want to have children. The operation involves actions aimed at preventing the fertilization of an egg by a sperm. Artificial obstruction is created through surgery. The effectiveness of this operation is 99 percent.

Indications for sterilization

Any woman over 35 years of age who has at least one child can undergo sterilization. Nevertheless, the issue of carrying out the operation should be approached responsibly. If there is no certainty that a woman will not want to have children again in the future, it is better to resort to other, less radical methods of contraception.

An indication for sterilization may be the fact that a woman is contraindicated to become pregnant, as well as the presence of a risk of transmitting hereditary defects, diseases or developmental abnormalities that are incompatible with life.

Operating principle of sterilization

During ovulation, the egg is released from the ovary and moves along the fallopian tube towards the sperm for further fertilization. Sterilization creates an artificial obstruction of the tubes, which makes conception and pregnancy impossible.

Types

There are two types of sterilization for women:

  • Blocking patency fallopian tubes methods of clamping, ligation, excision.
  • Installation of a special implant (hysteroscopic sterilization)

Methods

Sterilization in women is carried out in three ways.

  • Laparotomy. Passed through an incision in abdominal cavity. Usually performed in collaboration with others abdominal operations, such as caesarean section.
  • Laparoscopy. Less invasive and most common method. It is performed through several small incisions around the navel.
  • Mini-laparotomy. It is performed through a small incision just above the pubic hairline. Most often performed in women with a history of pelvic surgery, inflammatory processes or those who are obese.

Carrying out the operation

During surgery to create an artificial obstruction using clamps, rings, or tubal ligation, the surgeon makes several small incisions in the abdomen. Using a laparoscope, he places plastic or titanium clips or silicone rings on the fallopian tubes, ties them, excises or cauterizes them. This sterilization method is usually carried out under general anesthesia. Sterilization of women takes about half an hour. After a few hours, the patient can be sent home.

If the fallopian tubes are unsuccessfully blocked using the previous method, a salpingectomy is performed - complete removal.

The implants are installed through the vagina using local anesthesia. It is also possible to use sedatives. Using a hysteroscope, titanium implants are placed in each of the fallopian tubes. Obstruction is created by the formation of scar tissue.

After sterilization

After surgical sterilization, women should avoid intense exercise for a week. If pain occurs, you can take painkillers. But if discomfort increases, you should consult your doctor. If purulent discharge appears and vomiting persists for more than 24 hours, elevated temperature above 38 degrees, discomfort during urination, you also need to visit a specialist for an in-person consultation.

You can return to work in a few days. Sexual life can be resumed after you feel better. After 10 days you should see a surgeon to remove the stitches, and after 6 weeks for an examination.

Theoretically, female sterilization has an immediate contraceptive effect. But it is still recommended to use combined hormonal agents contraception, for example oral tablets, within a week after sterilization.

The effect of hysteroscopic sterilization occurs after 3 months. Because of this, the entire period after surgery should be used additional method contraception. You can stop using birth control only after ultrasound examination or x-ray to confirm that the implants are installed correctly.

Side effects

After sterilization surgery, a woman may experience discomfort, expressed in the following symptoms:

  • pain and nausea during the first four to eight hours;
  • convulsions during the first day;
  • vomit;
  • temperature.

Pros of sterilization

There are pros and cons to female sterilization, just like with any other operation. In addition to constant contraception and confidence in the absence of the risk of unwanted pregnancy, the following positive factors are present when performing this operation:

  • fast recovery;
  • most women can return to normal activities within one day;
  • the procedure does not take much time;
  • There is no need to go to the hospital; the procedure can be performed on an outpatient basis.

Consequences of female sterilization

After surgery in women, depending on the methods used, there is a risk of developing the following complications.

Besides all the complications and risks, the main disadvantage of female sterilization is its 99 percent effectiveness. There is less than a one percent chance that pregnancy will occur, and most likely it will be ectopic. The only 100% guaranteed methods of contraception are spaying and abstinence.

Contraindications to sterilization

  • Doubts about the decision made regarding the operation.
  • Pregnancy.
  • Allergy to nickel, silicone.
  • Childbirth, abortion, miscarriage less than 6 weeks ago.
  • Recent inflammatory or infectious diseases of the pelvic organs.
  • unknown origin.
  • Gynecological malignant processes.

The procedure is carried out as usual, but with additional preparation in the following cases:

  • young age;
  • obesity;
  • performing an operation during a caesarean section;
  • increased blood pressure;
  • history of ischemia, stroke, uncomplicated and congenital heart disease;
  • epilepsy;
  • depression;
  • diabetes:
  • uterine fibroids;
  • Iron-deficiency anemia;
  • compensated cirrhosis;
  • mammary cancer;
  • liver tumors.

Alternative methods of contraception

Apart from female sterilization, there are less radical methods long-term contraception, for example the use of subdermal implants, installation of an intrauterine hormonal or non-hormonal device. Unlike surgery, these methods also have some advantages, such as the absence of surgical risks and reversibility.

Along with female sterilization, there is also male sterilization - vasectomy. This involves dressing or removing seminal ducts. This operation carries much fewer risks and complications than surgical sterilization of women.

In addition to long-term contraception, combination contraceptives can be used to protect against unwanted pregnancy. oral contraceptives, various vaginal creams or suppositories, rings or patches. The simplest and most accessible is the barrier method - male and female condoms.

Sterilization of women. Reviews

Not everyone will be able to decide on such a radical method of contraception as sterilization. Typically, women come to make such decisions after the occurrence of unplanned pregnancies, for example, due to the absence of menstruation after a recent birth. There are also situations when one or another method of contraception does not work. Often, having tried almost all available methods of preventing unwanted pregnancy, a woman has no choice but to resort to sterilization.

According to statistics, after surgery, many women experience pain and nausea, which can be relieved with medications. After a few days everything returns to normal.

Some women who have sterilization later regret it. the decision taken.

Main aspects

Sterilization in women is an almost 100% method of contraception. However, it does not protect against sexually transmitted infections. Therefore, if a woman does not have confidence in her sexual partner, it is worth using barrier method contraception - condoms.

Sterilization in women does not cause menopause or affect women's sexual desire or enjoyment of sex. After the operation, the ovaries will continue to work as usual, and menstruation will occur as before.

Sterilization in women is entirely voluntary.

Finally

Whatever the benefits of sterilizing women, before you accept such important decision, it’s worth weighing the pros and cons. It is important to remember that this method is irreversible. Subsequent pregnancy is possible only with the use of reproductive technologies (in vitro fertilization) or the creation of artificial fallopian tubes. You should not decide to undergo sterilization if a woman is depressed, especially after a recent miscarriage, abortion or childbirth. Before carrying out voluntary sterilization of women, you should familiarize yourself with all the advantages, disadvantages of the operation, risks and possible complications after it.

Surgical sterilization- the most effective method of preventing unwanted pregnancy and therefore is becoming increasingly popular not only in developed but also developing countries. The Pearl index, or “contraceptive failure” rate, does not exceed 0.4% (0.4 pregnancies per 100 women per year).

There is a distinction between surgical sterilization of men and women. Approximately 60% of operations are performed on women and 40% on men.

Contraindications (for women) are divided into absolute and relative.

Absolute contraindications for women:

1. Pregnancy.

Relative contraindications for women:

1. Excess weight body or obesity.

2. Adhesive disease abdominal and/or pelvic organs.

3. Chronic diseases heart and lungs, severe diabetes mellitus, etc.

4. Umbilical or inguinal hernia(during laparoscopic surgery).

Basics contraindication for surgery in men- hemophilia.

It is important to explain to men and women that restoring fertility ( reproductive function) after surgical sterilization is possible, but not always, so they talk about the “irreversibility” of this method. Surgeries aimed at restoring fertility are expensive and often ineffective. Before sterilization, you need to talk about distinctive features one or another surgical intervention and possible complications, inquire about the health of children and the stability of marriage. The fact is that, according to statistics, one out of three women regrets sterilization and asks to “restore” her fertility. This is usually associated with a new marriage, the death of a child, or the desire to have more children. Average age operated for the purpose of sterilization for approximately 30 years. Requests to restore fertility are often addressed to more at a young age, which is associated with divorces and new marriages.

It should also be remembered that any operation, even a small one, carries a risk of death. Therefore, surgical sterilization is not the safest, although it is the most effective method of contraception. The mortality rate for female sterilization ranges from 3 (in the United States) to 10 (in other countries) cases per 100,000 operations, which is significantly lower than the mortality rate from pregnancy and childbirth.

In order to sterilize men, a vasectomy, or vasoresection, is performed - excision of part of the vas deferens. This operation is performed on an outpatient basis, under local anesthesia. Through small skin incisions on the scrotum on both sides, the ducts are brought into the wound and their parts are removed (resected). Long-term observations have shown that vasectomy does not lead to impotence, accelerated development of atherosclerosis and prostate cancer. Many men experience increased sexual potency after a vasectomy. If a man requests to restore fertility, a microsurgical operation is performed to restore the patency of the vas deferens - vasovasostomy. The success of this operation depends on the time that has passed since the vasectomy; Fertility is restored only in 30-40% of cases. 10 years after sterilization (vasectomy), reconstructive surgery (vasovasostomy) is considered inappropriate. The probability of pregnancy in a woman whose sexual partner has undergone vasovasostomy is approximately 50%. Therefore, a man who has had a vasectomy should consider sterilization irreversible. Deaths after vasectomy in developed countries not observed (in developing countries 1 case per 200,000 procedures); Complications are rare, mainly hematoma (collection of blood).

In women, sterilization is usually associated with “tubal ligation.” In reality, the fallopian tubes can be ligated, cut, crushed with a clamp, and then tied. You can resect the fallopian tubes (remove sections of them from different processing the remaining ends), remove fimbriae (fimbriae about 1-1.5 cm long, designed to capture the egg and bordering the abdominal openings of the tubes); Place special rings or brackets on the pipes. They use thermal energy methods (mono- and bipolar electrosurgery, diathermy) and laser surgery methods. Today, there are many methods for creating artificial obstruction of the fallopian tubes; a description of each of them, indicating the name of the author, is beyond the scope of this article; this information is of interest only to operating gynecologists. The choice of operation depends on the personal preferences of the surgeon, his experience, and technical capabilities. medical institution and its traditions. However, every woman needs to get answers to two basic questions. What access will be used for sterilization? Sterilization can be performed during laparoscopy, mini-laparotomy, conventional laparotomy, or through the posterior vaginal fornix. Laparoscopic access is the least traumatic and can reduce hospital stay to 2-3 days. During minilaparotomy, a transverse incision is made in the anterior abdominal wall above the pubis, 3-4 cm long. Sterilization can be performed during a routine operation (laparotomy), which is now rare, or during another operation on the abdominal organs, as well as during a cesarean section. In the latter case, the desire to perform sterilization should in no case influence the choice of method of delivery, since a caesarean section for the fetus may be more dangerous than childbirth through natural birth canal. Tubal ligation can be performed through an incision posterior arch vagina. However, after such an operation (posterior colpotomy), abstinence from sexual activity is required due to wound healing. It was noted above that tubal sterilization should be treated as a permanent or irreversible method, given the lack of guarantee of subsequent restoration of tubal patency and, therefore, fertility. With the above methods of tubal sterilization, the likelihood of restoring fertility varies. Therefore the second important question consists in choosing the operation after which the chance of restoring the patency of the fallopian tubes is high or, conversely, very low. In other words, there are situations when reconstructive plastic surgery on the fallopian tubes is impossible due to the nature of the sterilization performed. The prognosis is poor if the length of the fallopian tubes is less than 4 cm (this can be found out during diagnostic laparoscopy). Even after “gentle” sterilization with minor damage to the tubes, restoration of fertility, as already mentioned, is not always observed, despite the highly qualified surgeon. According to statistics, after successful reconstructive surgeries, the incidence of ectopic pregnancy increases. In case of unsuccessful surgery, in vitro fertilization is offered.

Other methods of sterilization of women include extirpation (removal) of the uterus, hysteroscopic transcervical (through the cervix) occlusion (blockage) of the fallopian tubes by introducing various sclerosing substances into their lumen, and destruction of the endometrium.

In Catholic hospitals, where tubal ligation was prohibited, hysterectomy was performed for the purpose of sterilization. Considering that this is a serious operation that can be accompanied by severe complications, at present it is performed for this purpose only if there is concomitant pathology: endometriosis, symptomatic uterine fibroids, ovarian tumors, uterine prolapse.

Interestingly, tubal ligation reduces the risk of developing ovarian cancer over 20 years. Then this effect gradually fades away. The same results were observed after hysterectomy without appendages.

Recently, the US has begun using a spring-like device (microcoil) called Essure, which is inserted into each fallopian tube using a hysteroscope (a device designed to examine the uterine cavity). This microspiral (not to be confused with a regular intrauterine device!) causes fibrous tissue to grow in the tubes, making them impassable for sperm. Despite some advantages (no need for general anesthesia, high efficiency), removal of Essure is possible only during surgery, through an incision of the fallopian tube, which in the future can lead to an ectopic pregnancy; Removal hysteroscopically is often not possible due to extensive fibrosis.

Destruction (destruction) of the endometrium leads to amenorrhea. Destruction can be performed using electrocoagulation, cryo- (cold) and laser exposure. For contraception purposes, these methods are usually not used. They are used for concomitant pathologies: recurrent glandular cystic endometrial hyperplasia, adenomyosis (uterine endometriosis), endometrial polyps.

Sterilization does not protect against venereal diseases and HIV infection. Therefore, it is important to be aware of the need for correct and consistent use of condoms in order to prevent infection and transmission of HIV after sterilization. Indications and contraindications for sterilization in HIV-infected persons are the same as in those not infected with HIV.

The decision to sterilize should be made taking into account the current legislation on this issue. An informed decision is required, given that this method of contraception is considered irreversible.

Sterilization is used to deprive a person of the ability to reproduce. Surgical sterilization as the most effective method of contraception is used in the treatment of various diseases, for birth control, and also as a compulsory measure of punishment for crimes committed.

Everyone around the world uses tubal sterilization and vasectomy. large quantity women than other methods of contraception.

Sterilization of the fallopian tubes, although very effective method but there is still a risk pregnancy, depending on the age of the person.

Regular appointment birth control pills has an adverse effect on the female body.

Today, the most effective method of birth control is considered tubal ligation, because after this procedure is successfully completed, the woman practically cannot become pregnant again.

Sterilization of women is mainly carried out under general anesthesia however, depending on the method used, it can also be performed under local anesthesia.

Surgery involves sealing or blocking the fallopian tubes connecting the ovaries to the uterus.

Consequences: once the sperm reaches the female egg, fertilization becomes impossible.

1. The effectiveness of female sterilization in most cases is 99% and only in one case out of 200 is pregnancy possible, even if surgery is performed.

2. Not worth it think about it every day, every time during sex, since sterilization cannot interrupt or influence the sexual life of partners.

3. The procedure can be carried out even during menses. It does not affect hormone levels.

4. Sterilization does not lead to disruption of the menstrual cycle.

5. In any case, after the operation you will not need to use contraceptives: neither before next menstruation, nor for three months after it. This depends on the type of sterilization.

6. At surgical intervention Various complications may occur: infectious diseases, internal hemorrhage or damage to neighboring organs.

7. There is also risk that the operation will not work: the fallopian tubes may recover immediately or years later.

8. After unsuccessful surgery, the risk increases ectopic pregnancy, when the fertilized egg is outside the uterus.

9. Sterilization operation is difficult to turn around reverse.

10. Female sterilization doesn't protect from various infectious diseases sexually transmitted diseases. Therefore, in order to protect yourself and the health of your partner, you must use a condom during intimacy.

Operating principle of sterilization

Female sterilization is designed to prevent eggs from traveling down the fallopian tubes. This means that the sperm cannot meet the egg, as a result of which fertilization does not occur.

How is female sterilization carried out?

Exist two main types of female sterilization:

For many women, such operations are minor. Tubal occlusion is often used.

Tubal occlusion

First of all, the surgeon must perform a mini-laparotomy or laparoscopy in order to examine and check the fallopian tubes. Mini-laparotomy involves performing a small, less 5 cm(about two inches) cut made slightly above the pubic hair. Through the incision, the surgeon will be able to view the fallopian tubes without any problems.

Laparoscopy is the most common method of accessing the fallopian tubes. The surgeon makes a small incision in the abdominal cavity near the navel and inserts a small flexible tube called a laparoscope equipped with a tiny light and camera. The camera displays an image of the inside of the body on a television monitor. This allows the surgeon to see the fallopian tubes more clearly.

Laparoscopy is the most preferred method of female sterilization as it is faster than mini-laparotomy. However, the last type of sterilization is recommended for women:

  • who have recently been exposed to pelvic or abdominal surgery
  • those suffering redundant weight, that is, their body mass index exceeds 30 kg
  • who have suffered various inflammatory diseases pelvic organs, because the infection can have an adverse effect not only on the fallopian tubes, but also on the uterus itself

Blocking pipes

The fallopian tubes can be blocked using one of the following methods:

  • special titanium or plastic clips used to clamp the fallopian tubes
  • usage rings involves making a small loop of the fallopian tube, which is threaded through it
  • tying or cutting the fallopian tube

Uterine implants (hysteroscopic sterilization)

National University of Health and social security published guidelines for hysteroscopic sterilization. In the UK, Essure technology is used for hysteroscopy. Implants are installed under local anesthesia. Along with this, you can also take a sedative.

A narrow tube with a telescope at the end, called a hysteroscope, enters the vagina and cervix. A wire is used to insert a tiny piece of titanium into the hysteroscope and then into each fallopian tube. During the procedure, the surgeon does not need to make an incision in the woman's body.

The implant causes formation around the fallopian tubes scar tissue, which subsequently blocks them.

You should worry about using contraception until there is visual confirmation that your fallopian tubes are blocked. This can be done using the following methods:

  • hysterosalpingogram (HSG) - an x-ray examination in which the uterine cavity is examined. This method involves the injection of a special dye in order to show the fallopian tubes
  • Contrast hysterosalpingosonography – a type of ultrasound using injected dyes into your fallopian tubes

Salpingectomy (removal of fallopian tubes)

Incorrectly performed surgery on the fallopian tubes can lead to complete removal. This procedure is called a salpingectomy.

Woman before surgery

Before sterilization surgery is performed, a woman should consult a doctor.

This will provide an opportunity to talk in detail about the operation, what questions, doubts and concerns most often arise during it.

If a woman agrees to sterilization, the doctor refers her for treatment to the nearest medical facility to a gynecologist - a specialist in the field of the female reproductive system.

If you choose sterilization, you will be asked to use contraception before and after surgery:

Sterilization can be done at any stage of your menstrual cycle.

Before surgery, you will need to take a pregnancy test to make sure you are not pregnant. This is very important because if the fallopian tubes are blocked there is high risk that the pregnancy may be ectopic.

An ectopic pregnancy can be life-threatening as it can cause severe internal bleeding.

Woman after surgery

After the anesthesia wears off, you need to have your urine tested, eat a little, and then you will be allowed to go home. IN medical institution where the operation took place, they will tell you what to expect and how to take care of yourself after sterilization, they will leave your contact number so that you can call if any problems or questions arise.

Advantages and disadvantages

Advantages:

  • Sterilization in 99% helps avoid unwanted pregnancy.
  • Blocking or removing pipes is effective immediately.
  • Hysteroscopic sterilization is effective, as a rule, after three months.
  • Does not provide influence on a woman's health, her erogenous zones and the sexual act itself.
  • Does not affect to hormonal levels.

Flaws:

  • Does not protect against sexually transmitted diseases.
  • It is difficult to repair blocked fallopian tubes.

Side effects and consequences

1. If the fallopian tubes are obstructed, there is a risk of complications - infections, internal bleeding and damage to other organs.

2. After sterilization, a malfunction may occur: the fallopian tubes will connect, and you will be able to again get pregnant.

3. If you become pregnant after surgery, there is a risk that it will ectopic.