Science Questions

What are the risks of sterilisation?

Sun, 8th Nov 2009

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Question

Singing Fish, via twitter asked:

What are the risks associated with tubal ligation and vasectomy?

Answer

Chris: -   Okay. So these are methods of sterilisation. Tubal ligation means that you go inside the peritoneal cavity in the woman, in the pelvis. You identify the fallopian tube on each side. You can see that quite easily because theyíre about 5 mm across, and you clamp them. You put a very large paper clip which is squashed onto the tube, and it crunches the tube closed.  And the idea of that is that then what it does is basically squashes the tubes so that the egg released by the ovary cannot make its way down the tube to get into the uterus. And at the same time, a sperm cannot get along the tube to meet the egg and fertilize it. Otherwise, you might get the risk of whatís called an ectopic pregnancy, the actual egg starting to be fertilized and grow outside the uterus.

The risks of tubal ligation are that it doesnít work. Itís a small risk but thereís nonetheless a risk that you could fail to completely close off the pathway. Another possibility with any invasive procedure is, of course, that you can cause pain.  You could cause bleeding. You could get a localized infection.

With vasectomy, it's a very safe procedure, pretty similar though. You basically are cutting, folding back on themselves and tying off the vas deferens, which are the tubes that carry sperm from the testicle up inside the body. The idea being that then you interrupt the route that the sperm will follow after the testes. The risks are pretty similar to having tubal ligation and the fact is that occasionally there is incomplete severance.  There may be a route by which sperm can still make it through. Also, you donít stop being fertile. The minute you have it done thereís a flush out or a washout period afterwards.

And so if someone just has a vasectomy and then assumes theyíre now no longer capable of fathering children, they could be in for a shock.

Helen: -   And presumably the same question that we had before comes up here that sperm - oh and the testicles that, if itís not got any way of getting out, it just stays there: but also is broken down over time if itís not actually released.

Chris: -   Yeah, you donít end up with your testicles expanding pervasively.

Helen: -   I did always wonder about that, actually.

Chris: -   With all the trapped sperm thatís, sort of, left stuck there.  Unfortunately, no it doesnít happen.  Thankfully, I suppose.  (Laughing)  In fact, itís just basically broken down and those cellular constituents get recycled.

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