- Definition. A surgical procedure that is aimed at permanently blocking or removing part of the female or male genital tracts to prevent fertilization.
- Frequency. The most common method of family planning worldwide. More than 220 million couples use surgical sterilization for contraception, 90% of whom live in developing countries.
- Ratio of female : male sterilization is 3 : 1.
- Risks. All patients undergoing surgical sterilization should be aware of the nature, efficacy, safety, and complications of the operation as well as alternative methods of contraception. Patients should be informed of the risk of regret. Many couples are under the false impression that sterilization procedures are easily reversed. It is the responsibility of the surgeon to make it clear that such procedures are intended to be permanent.
Female sterilization
- Can be performed at cesarean delivery, immediately postpartum, post-abortion, or as an interval procedure unrelated to pregnancy.
- In developing countries, tubal ligation is generally a popular form of birth control and is widely available, although some Muslim countries (e.g. Egypt and Indonesia) do not permit it.
- Faith-based medical institutions in developed countries will sometimes refuse to perform tubal ligations.
- Advantages. Tubal ligation is permanent, effective, and safe. Long term, it reduces a woman’s risk of developing ovarian cancer by 50%.
- Complications. The mortality rate (4/100,000 procedures) mainly reflects anesthetic risks. Other potential complications include hemorrhage, infection, erroneous ligation of the round ligament, and injury to adjacent structures.
- Regret. The strongest indicator of future regret is young age (age <25) at the time of sterilization. Risk factors for regret also include parity, marital status, and health of children.
- Reversal.
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