Sterilisation

Question 1

How is female sterilisation most commonly performed?

Answer 1

Laparoscopically under GA.

Filshie clips are applied to the tubes.

Question 2

What are the other ways in which female sterilisation can be done?

Answer 2

At C-section a section of each tube can be excised.

Transcervical involves placement of micro inserts into the proximal part of each lumen, these will expand and cause fibrosis occluding the lumen.

Question 3

How successful is female sterilisation?

Answer 3

It has a 99.5% efficacy the same as the mirena coil (IUS).

Question 4

What should be discussed when counselling a patient who is considering sterilisation?

Answer 4

Insure they have finished there family

Discussed alternative contraception

Warn of failure risk and the fact that efficacy is equal to mirena

Not reversible

Surgical risks

Question 5

What are the risks associated with the female sterilisation?

Answer 5

Safe procedure but risks include:

• Visceral damage to (bowel or bladder)
• Laparatomy may be needed
• Post op-pain
• If pregnancy after surgery likely to be an ectopic

Note risk of pregnancy until women has first period so contraception should be used until then.

Question 6

How is a vasectomy performed?

Answer 6

Under LA a small part of the vas deferens is removed. Sterility is confirmed with 2 negative semen analysis.

Question 7

How effective is a vasectomy?

Answer 7

After negative sperm samples lifetime risk is 1 in 2000

Question 8

What are the complications of vasectomy?

Answer 8

Failure
Post op haematoma and infection
Chronic pain

Can be reversed but natural conception may be restricted after this.