Tubal Occlusion or removal of both Tubes
Female sterilisation is an operation to permanently prevent pregnancy. The fallopian tubes are blocked or sealed to prevent the eggs from reaching the sperm and becoming fertilised.
At a glance: facts about female sterilisation
Female sterilisation is more than 99% effective at preventing pregnancy.
You don't have to think about protecting yourself against pregnancy every time you have sex, so it doesn't interrupt your sex life.
It doesn't affect your hormone levels and you'll still have periods.
You'll need to use contraception up until you have the operation, and until your next period.
As with any surgery, there's a small risk of complications, such as internal bleeding, infection or damage to other organs.
There's a small risk that the operation won't work – blocked tubes can rejoin immediately or years later.
If the operation fails, this may increase the risk of a fertilised egg implanting outside the womb (ectopic pregnancy).
Sterilisation is very difficult to reverse, so you need to be sure it's right for you.
Sterilisation doesn't protect against sexually transmitted infections, so you may need to use condoms as well.
How it works
Female sterilisation works by preventing eggs from travelling down the fallopian tubes, which link the ovaries to the womb (uterus). This means a woman's eggs cannot meet sperm, so fertilisation cannot happen.
Eggs will still be released from the ovaries as normal, but they'll be absorbed naturally into the woman's body.
What are the types of laparoscopic sterilisation?
There are two main ways of performing laparoscopic female sterilisation (a type of keyhole surgery).
The first, more common, method of laparoscopic sterilisation is where the gynaecologist places specially designed clips on the tubes. These clips crush the tubes causing a small portion to be blocked. The clips remain in the body. Sometimes they migrate after they’ve done their job and this rarely causes problems. If you change your mind, an attempt at reversal with reconnection of the tubes may be tried following this type of sterilisation, but reversal is unreliable with only about a 60-70% success rate.
The second method of laparoscopic sterilisation is to remove both fallopian tubes completely. This is a slightly more involved procedure. It’s probable that the failure rate is less with this method than clip sterilisation. Also, it has the advantage of leaving no clips in the body. This method of sterilisation can not be reversed, with IVF necessary if you change your mind and want to get pregnant. A probable additional benefit of this type of sterilisation, is that it probably reduces the life-long risk of ovarian cancer by about 50%. It is thought that many 'ovarian' cancers actually originate from the ends of the fallopian tubes, so removing them prevents this from happening.
How is laparoscopic sterilisation performed?
The procedure is performed under general anaesthesia. A few small incisions are made, one in the navel and one or two low down above the pubic bone. The laparoscope (small camera) and instruments are used to access the fallopian tubes .
Is sterilisation right for me?
Almost any woman can be sterilised, but it should only be considered by women who don't want any more children. Once you're sterilised it's very difficult to reverse it, so consider all options before making your decision. Sterilisation reversal isn't usually available in the public sector and not usually funded by your health fund.
Before the operation
Your GP may recommend counselling before referring you for sterilisation. This can involve your partner, if you would like, but it doesn't have to. Counselling will give you a chance to talk about the operation in detail, and discuss any doubts, worries or questions you might have.
You'll need to use contraception until the day of the operation, and right up until your next period after surgery if you're having your fallopian tubes blocked.
Sterilisation can be performed at any stage in your menstrual cycle.
Before you have the operation, you'll be given a pregnancy test to make sure you're not pregnant.
Recovering after the operation
You'll be allowed home once you've recovered from the anaesthetic, been to the toilet and eaten. Ask a relative or friend to pick you up, as you are not allowed to drive within 24 hours after a general anaesthetic.
How you will feel
It's normal to feel unwell and a little uncomfortable if you've had a general anaesthetic, and you may have to rest for a few days. Depending on your general health and your job, you can normally return to work 5 days after tubal occlusion, but avoid heavy lifting for about a week.
You may have some slight vaginal bleeding. You may also feel some pain, like period pain – you can take painkillers for this. If the pain or bleeding gets worse consult your GP or Dr Swanepoel.
Caring for your wound
You'll have a few small (5mm) wounds covered with a special skin glue, which is transparent and water resistant, so you can shower straight away. This skin glue will start to peal off in 10-14 days. Report any purulent discharge, pain or swelling.
Your sex drive and sex life shouldn't be affected. You can have sex as soon as it's comfortable to do so after the operation.
If you had tubal occlusion, use additional contraception until your first period to protect yourself from pregnancy.
Sterilisation doesn't protect against sexually transmitted infections (STIs), so you may need to use condoms.
Advantages and disadvantages of female sterilisation
More than 99% effective at preventing pregnancy.
Blocking the fallopian tubes and removal of the tubes should be effective immediately – but use contraception until your next period.
It won't affect your sex drive or interfere with sex.
It won't affect your hormone levels.
It doesn't protect against STIs, so you may need to use condoms.
It can't be easily reversed, and reversal operations are rarely funded by Medicare or Health funds.
It can fail – the fallopian tubes can rejoin and make you fertile again, although this is rare.
There's a very small risk of complications, including internal bleeding, infection or damage to other organs.
If you get pregnant after the operation, there's an increased risk that it will be an ectopic pregnancy.