A safe and relatively simple sterilization operation is gradually gaining acceptance throughout the world. Before long, it may develop into the main way of giving women total birth control on a long-term basis.
The procedure is straightforward in most cases, the risks are slight, and the results are excellent. For a surgical operation, it requires the minimum of nearly everything. Some surgeons have their patients in and out of hospital the same day, although others prefer to keep them there for a couple of days.
Convalescence is short, and absence from normal working duties is not long. Often, a return to work after one week or less is possible. The patient usually feels great within a day or two of surgery and the limitations and restrictions are minimal.
The operation is extremely popular in many western countries, as women seek to limit their families in the simplest way possible. In one year nearly three-quarters of a million American women underwent tubal sterilization by the laparoscopic method.
It is relatively popular in England, and since it was introduced to Australia not long ago many women have had the operation. What is more it is fairly modest in cost, largely because of the short stay in hospital. Medical and hospital benefit organizations cover the bulk of the expense.
No side effects
Many women are appalled at the thought of having to take the oral contraceptive pill every night for 25 years. Well over one million American women regularly consume the pill. Despite its relatively good track record since formulations were reduced a few years ago there are still many who find they dislike the side effects such as headache, depression and weight increase.
Loss of libido and normal pleasure with love-making are high on the list of undesirable side effects. Sore breasts, brown splotches on the skin, irritability, muscle cramps, and the risk of clot formation with potentially dire results are still in the minds of many women.
So, although it is excellent when reversible contraception is desired – say for younger women still planning their families – it becomes less necessary for those who do not wish to bear more children. This means that the operation appeals most to women in their mid to late 20s and onward.
Sterilization offers permanent birth control, with absolutely no need to worry in the future. It can be performed on either male or female. For some reason Australian males seem to prefer their women to undergo the operation. This is quite different from America where the rate is roughly 50 – 50.
The operation is quite straightforward. It involves a small incision about ½ cm (¼ inch) in length just under the navel. Through this the gynecologist introduces the laparoscope. This is a metal tube fitted with lenses and lights. It gives him a view of the entire pelvic area. He can readily pick out the uterus (womb), fallopian tubes and ovaries, plus other structures.
Then via another small incision – perhaps a ½ cm (¼ inch) in length and made approximately where an appendectomy incision would be – he introduces another instrument, the cautery.
The tube is picked up by a hook on the end of the cautery device and a cauterizing current immediately seals off the tube by searing heat. With another quick charge the tube is entirely severed, leaving two free sealed ends.
Some surgeons actually remove a length of the tube to make sure the two ends do no meet up again and re-canalize. (That means the tubes becoming joined and the hollow canal down which the egg passes, re-uniting so allowing pregnancy to occur again.)
The risk of the ends re-joining are not high but with the passage of time and with nature as fickle as she is, the tubes have been known to reunite and reopen. After the operation the incisions are usually closed with one or two stitches that are removed after about a week.
A general anesthetic is frequently given. Often the gynecologist will clean the womb to make certain there is no disease or abnormality present. Some surgeons prefer their patients to have a full pubic preparation with the pubic hair being shaved completely.
However, many now do not insist on this, or have only a mini-prep carried out. The dressing over the wounds is often little more than plaster – the Americans often speak of this as “band-aid surgery.” Certainly the scarring that follows is minimal.
Is it possible to reverse sterilization?
The question that regularly crops up is: what if a woman later changed her mind and wanted a child?
It is interesting to note that Australia recently scored a first in this respect. A woman had a “reversal” operation carried out in a Sydney hospital. Microsurgery was undertaken, the sealed ends of the tubes “unsealed.” The final proof of a successful operation occurred when she became pregnant and produced a normal healthy child.
There is little doubt that more and more reversals will be carried out. Women will be heartened to know that the decision they make is not necessarily a binding one.
Most doctors tell their patients that the operation is not meant to be reversed, and this is the basic idea. However, if the circumstances occur, and very few women will be affected in this manner, then the future seems quite bright.
Contraception with this technique is instant. It is quite different from vasectomy where several weeks or even months must elapse (plus several pathology tests) before the final okay is given for safety.
There is absolutely no alteration in sensations. Libido is unaffected. Indeed, the break from normal marital relations is often quite short. Provided the patient feels all right, she can return to normal routines within a week or so.
Overweight patients are often the most unsuitable. So, if you’re thinking of having the operation and are overweight, start losing the excess right now.