Sterilisation (female, male) Flashcards
What is female sterilisation?
Surgical ligaiton or obstruciton of both fallopian tubes as permanent method of contraception.
What are the indications for female sterilisation?
Permanent contraception desire.
What is the methods of female sterilisation?
Laparoscopic: appication of occlusive clips on Fallopian tube (Filshie clips) or silicone rings.
Open method: after C section or if laparoscopy impossible. Pomeroy technique with loop of fallopian tube made and tied off. Parklend resection of tube and ligaiton of cut ends.
What are the advantages and disadvantages of female sterilisation?
Permanent, reliable.
BUT
Irreversible, failure rate 1/200, high risk of future ectopic, risks of surgery.
What are the complications of female sterilisation?
Bleed, infection, anasthetic, VTE, damage to other organs BBU, risk of conversion to open.
What is the prognosis of female sterilisation?
Failure rate a/a. Reversal success 30-70%.
What advice do you give to women concerning sterilisation?
o Method is irreversible (reversal requires high skilled and is difficult)
o Vasectomy is safer, quicker and associated with less morbidity
o High proportion of women regret sterilisation
o Does not protect against STIs
o Prior to the procedure, abstain from UPSI for 3 weeks and have a pregnancy test before the procedure
§ If the patient has had UPSI, the procedure should be deferred
§ Protected sex is ok
o Effective contraception is required until:
§ Laparoscopic procedure: the next menstrual period
§ Hysteroscopic procedure: 3 months
o Pregnancy following female sterilisation is rare but has an increased risk of ectopic pregnancy:
§ If missed period -> immediate pregnancy test
§ If +ve -> immediate USS to check location
Male not done
Male not done
