In the United States chooses one third who want to avoid pregnancy of couples, a vasectomy or tubal ligation, especially if the woman is> 30 years old. One should consider sterilization as definitive. However, if there is a baby, a Reanastomosis can restore fertility in 45-60% of men after vasectomy and 50-80% of women after tubal ligation. Also, an in-vitro fertilization are carried out successfully. Man (vasectomy) Sterilization For this method, the vas deferens is cut and ligated the severed ends or electrically scabbed. A vasectomy takes <20 minutes, it is done under local anesthesia. Sterility occurs only after 20 ejaculations after the operation and should be documented by two sperm-free ejaculate, which is usually made 3 months after surgery. Until then, another contraceptive should be used for security. For 2 to 3 days after surgery often leads to mild discomfort. During this time, NSAIDs and a waiver of ejaculation are recommended. Complications of vasectomy are hematomas (? 5%), Spermiengranulome (inflammatory responses to a sperm leak) and spontaneous Reanastomosierungen, which usually develop shortly after the procedure. The cumulative pregnancy rate after 5 years at 1.1%. Female sterilization, the fallopian tubes are severed uterine and cut out a piece for this method, or the tubes are closed by ligature, sloughing or various mechanical materials (plastic tapes, spring clips). Alternatively, the tubes can be closed. Sterilization with mechanical devices causes less tissue damage and can do better undo possibly. One of several methods may be employed, including laparoscopy, hysteroscopy minilaparotomy A tubal ligation may be performed during a cesarean section, or 1 to 2 days after a vaginal delivery over a small Periumbilikalschnitt (via laparoscopy). Laparoscopic methods of tubal ligation are traditionally considered interval methods (independent of a pregnancy) is usually> 6 weeks after giving birth in the operating theater performed under general anesthesia. The cumulative failure rate of the tubal ligation is about 1.8% after 10 years; However, some methods have higher failure rates than others. Postpartum procedures have lower failure rates than some laparoscopic procedures. In the hysteroscopic medical sterilization close hysteroscopically controlled the lumen of the fallopian tubes with micro inserts from spirals. The outer layer of the coils consists of a nickel / titanium alloy and the inner layer made of stainless steel and polyethylene terephthalate (PET). The PET fibers stimulate ingrowth, thereby closing the fallopian tube. Among the advantages of hysteroscopic sterilization compared to the tubal ligation include the following: You can be an outpatient basis in a clinic. It requires neither cuts, setting yet scabbing of the tubes. One drawback is that the sterility does not exist yet for up to 3 months after the onset of micro-inserts, as ingrowth, which closes the tubes, lasts several weeks. Therefore, doctors recommend usually use an alternative method for a period of 3 months after the procedure. Women should choose a method (eg. As depot medroxyprogesterone), which stabilizes the endometrium and enables visualization during hysteroscopy. This method can be applied to detection of the tube closure by hysterosalpingography 3 months after sterilization. for the detection of the tube closure ultrasound if an allergy to contrast agents is made, can be used. A minilaparotomy is occasionally used instead of laparoscopic sterilization, usually when the women want to be sterilized soon after the birth of the child. It is a general, regional or local anesthesia required. For this, a small abdominal incision (about 2.5 to 7.6 cm) is made and removes a portion of each Fallopian tube. Compared to laparoscopy, the minilaparotomy is more painful, and recovery will take longer. After laparoscopic sterilization or minilaparotomischer no objects for about two weeks into the vagina (z. B. tampons, douches) is recommended, introduced and no intercourse are completed. Adverse effects of sterilization in women are rare. Some of these complications are death: 1-2 / 100,000 women bleeding or intestinal injury: about 0.5% of women Other complications (such as heart attack, failure of the occlusion.): Up to about 5% of women Ectopic Pregnancy: 30 % of pregnancies after tubal ligation Summary the patient should be definitive even if a re-anastomosis (if desired) fertility in about half of the men and can recover in women more sterilization. For men, the vas deferens to be cut through and ligated the severed ends or electrically scabbed; sterility is confirmed by two sperm-free ejaculations, usually after 3 months. For women, the Tubae uterinae be severed and cut out a piece, or the tubes are closed with micro inserts or by ligation, sloughing or mechanical materials such as plastic straps or spring clips; the procedures used are laparoscopy, hysteroscopy and minilaparotomy.

Health Life Media Team

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