Permanent Methods of Birth Control

All permanent methods of birth control performed by our physicians require a surgical procedure. All of the procedures are brief and performed as an outpatient at Flowers Hospital. This means that you arrive at the hospital on the day of your surgery and are able to go home several hours after your procedure.

Permanent methods should be considered to be just that—permanent. While tubal procedures can sometimes be reversed, this often involves a much larger procedure that does not guarantee success.

One of the greatest risks of permanent sterilization is regret. This is often dependent on the age at which a woman decides to have the procedure. In one of the largest trials to assess regret after permanent sterilization, young age at the time of sterilization was the strongest predictor of regret, regardless of marital status or the number of children a woman had. In women age 20 to 24 years at the age of sterilization, an average of 4.3% reported regret over the follow-up period. In women age 30 to 34, the rate of regret was significantly lower at 2.4%.

We have described below the procedures available through our office for sterilization (except vasectomy!).

Bilateral Tubal Ligation, or Getting Your “Tubes Tied”

The fallopian tube is a structure that is attached to and opens into the uterus. The fallopian tube allows two things; the sperm can travel through the tube to reach the egg for fertilization and the egg can travel through the tube to reach the uterus. A tubal ligation closes this tube off so that sperm and egg cannot reach each other. A tubal ligation can be performed the day after a vaginal delivery, at the time of cesarean section, or as a completely separate procedure. The procedure is effective immediately. Failure rate is less than 1 woman per 100 per year.

Description of the procedure:

If performed as a separate procedure, a tubal ligation is done laparoscopically, typically through two small incisions less than 1cm in size. A camera is placed through one of these incisions and the operating device through the other. The tube can be cut, sealed with clips, or a segment of tube removed. If performed on the day after a vaginal delivery, an incision is made at the base of the belly button and the tubes reached through this. Again, the tube can be cut, sealed with clips, or a segment removed.

Essure

Essure is a procedure that was developed as the “first non-surgical method of sterilization.” In other words, while it is performed in the operating room, the tube does not have to be cut or burned through abdominal incisions. The Essure procedure involves having a spring-shaped device placed into the opening of the fallopian tube. This device scars into the tube, blocking egg and sperm from reaching each other.

Description of the procedure:

In the operating room, a small camera is inserted through the cervix into the uterus. The opening of both tubes is visualized with this camera. A thin tube is placed into the tube opening and the springs released into the tube. Because it takes time for the scar tissue to generate, a backup method of birth control must be used in the first 3 months. At the end of that time, a procedure called a hysterosalpingogram (HSG) is performed. This is done in the radiology department at Flowers. Dye is injected through the cervix and an x-ray taken to ensure that the tubes are complete blocked.

For more information, please go to: www.essure.com

Adiana

Adiana is also a procedure that is performed in the operating room. As with the Essure, the tube does not have to be cut or burned through abdominal incisions. The Adiana procedure involves two steps. First, a small amount of heat is generated and delivered to the inside of the tube. Then, a soft insert is placed into the tube where the energy was applied. This insert scars into the tube, blocking egg and sperm from reaching each other.

Description of the Procedure:

In the operating room, a small camera is inserted through the cervix into the uterus. The opening of both tubes is visualized with this camera. A thin tube is placed into the tube opening and a small amount of heat is generated and delivered to the inside of the tube. Then, a soft insert is placed into the tube where the energy was applied. Because it takes time for the scar tissue to generate, a backup method of birth control must be used in the first 3 months. At the end of that tinme, a procedure called a hysterosalpingogram (HSG) is performed. This is done in the radiology department at Flowers. Dye is injected through the cervix and an x-ray taken to ensure that the tubes are completely blocked.

For more information, please go to: www.adiana.com

Vasectomy

A vasectomy prevents sperm from reaching the penis. With a vasectomy, the content of seminal fluid is changed only in that it does not contain sperm. If your partner gets or has had a vasectomy, a backup method of birth control must be used in the first 3 months to prevent pregnancy.

If your partner is interested in a vasectomy, we are happy to refer a urologist who can perform the procedure.