Permanent Sterilization

Permanent sterilization for women may be performed by tubal ligation or a minimally invasive hysteroscopic procedure called Essure.   Permanent sterilization for men consists of an in-office procedure called vasectomy.  The most important thing to realize about permanent contraception is that it is indeed permanent and intended to prevent pregnancy for the rest of your life.   Studies have demonstrated that regret regarding permanent sterilization is highest in younger women, especially women who are less than 30 years old.

Tubal Ligation

Bilateral tubal ligation is approximately 99% effective in preventing pregnancy and is effective immediately following the procedure.  If pregnancy does occur following tubal ligation, there is an increased risk of ectopic pregnancy, a dangerous situation where the pregnancy develops outside of the uterus, usually in the fallopian tube itself.  In fact, up to 1/3 of post-tubal ligation pregnancies are ectopic pregnancies.  

Tubal ligation may be performed at the time of c-section, immediately post partum after a vaginal delivery and via laparoscopic surgery.  At the time of c-section, tubal ligation is usually accomplished by tying off both fallopian tubes with dissolvable suture and excising a small portion of each tube.  The tubal ligation procedure post partum is similar and performed through a small incision, typically about 1-2 inches in size, just below the belly button.  Laparoscopic tubal ligation requires general anesthesia and 1 or 2 tiny abdominal incisions, approximately ½ inch in length.  During this laparoscopic procedure, both fallopian tubes are obstructed by either applying heat energy to burn a small portion of each tube or by applying a clip or ring across the tube.  The exact method of laparoscopic tubal ligation may vary by surgeon.

Hysteroscopic sterilization with Essure

Essure is a minimally invasive hysteroscopic sterilization surgery that involves placing a tiny, soft insert or coil within the fallopian tube.   Over a period of about 3 months, the insert or coil stimulates the body’s immune response to grow tissue around the device and block the fallopian tubes.   The procedure is a form of permanent sterilization that is 98.5-99.5% effective in preventing pregnancy.  

Essure procedures are performed via hysteroscopy, where a small camera is inserted through the cervical opening into the uterine cavity.  The uterine cavity is filled with fluid in order to visualize the inside walls of the uterus and the small openings were each fallopian tube inserts into the uterus.  The insert or coil is then placed into the fallopian tube without requiring any incisions or entry into the abdominal cavity.   Over the next 3 months, the body will grow tissue around and through the fallopian tube insert gradually blocking the tube.  A reliable back-up method of birth control is required for at least these first 3 months post-procedure because you are still fertile during this time period.   At 3 months post-procedure a special x-ray called a hysterosalpingogram (HSG) is ordered to confirm that both tubes are completely blocked.   Once this bilateral blockage is confirmed, the procedure is considered effective for permanent birth control. 

Essure procedures may be performed as an in-office procedure at our Durant Road location or in the operating room under sedation.  A Depo provera intramuscular injection is typically given at least 1 month prior to either of these hysteroscopic sterilization procedures to thin the uterine lining and optimize visualization within the uterine cavity.  This can also serve as your “back-up” contraception for after the procedure.

Koop Kam 2

Computer Drive Office
3805 Computer Drive
Raleigh, NC 27609

Durant Medical Center
10880 Durant Road, Suite 224
Raleigh, NC 27614

Office Hours
Monday-Wednesday 8:00 to 5:00
Thursday 8:30 to 5:00
Friday 8:00 to 4:00

Contact
Phone: 919-781-6200
Fax: 919-783-1819

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