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Reversal of sterilization

No woman should ever decide to have a sterilization procedure with the possibility of future reversal in mind. Reversal should never be relied upon as a fall-back plan. One important issue to consider is that, even when available, and this may be quite expensive, success rates hover around 60 – 70% only. There is also the risk that a pregnancy following reversal of sterilization could be ectopic, a potentially dangerous condition.

Potential complications of female sterilization

Female sterilization can fail in up to two in every thousand cases, which is really a low failure rate.

It may be technically impossible to perform by the keyhole (laparoscopic) approach, necessitating a bigger operation, which means a longer (three to four day) hospital stay.

Other internal organs, such as the bowel, may be injured during the procedure, and pelvic infection is a possible complication. There is also a very small risk of serious hemorrhage in case of injury to a major vessel in the abdomen.

While theoretically this looks a worrying list, in practice this is an extremely safe procedure and virtually everybody goes home the same day and resumes normal activities in less than a week.

Alternative ways of performing female sterilization

In the last few years, a different approach to female sterilization has been available as an option. This does not involve going through the abdomen. Instead the approach is vaginal. It is called hysteroscopic sterilization. This involves inserting special rods into the fallopian tubes approached via the vagina and womb cavity. It is done under telescopic (hysteroscopic) guidance. This procedure can be carried out while the patient is awake and as an outpatient procedure. It is, however, not yet universally available. One such method is branded Essure®. This sterilization method is completely irreversible.

Permanent contraception without being sterilized

For those women in steady relationships, male sterilization in the form of a vasectomy is just as simple, with a much lower failure rate ( 1 in 3000).

Vasectomy can and is usually performed using a local anesthetic only.