Permanent contraception (sterilisation)
What is it and how does it work?
Permanent contraception means sterilisation. Both men and women can be sterilised; in both cases, it works by stopping the egg and the sperm meeting.
In female sterilisation (tubal occlusion) this is done by cuttings sealing or blocking the fallopian tubes which carry an egg from the ovary to the uterus (womb). A general anaesthetic is required.
In male sterilisation this is done by cutting and sealing or tying the vas deferens (the tube that carries sperm from the testicles to the penis). This is called a vasectomy and is normally carried out under a local anaesthetic.
Both procedures are short and safe but male sterilisation is the simpler and more reliable of the two procedures.
How effective is it?
Although classed as permanent, there is a small risk of failure. Every so often, the tubes may re-join, meaning you will become fertile once again. With male sterilisation, about one in 2000 will fail. In female sterilisation, about 1 in 200 will fail.
Pros and cons
The advantages of sterilisation are that after it has worked, you don’t have to use contraception ever again.
The main disadvantage is that it takes between four weeks (female sterilisation) and three months (male sterilisation) to be effective.
Relevance in PH
You need to be absolutely sure you are ready to let go of any future chance to conceive. You need to take into account how you would feel if there were medical advances in the treatment of PH that might make pregnancy a safer option than it is now.
Q. Can sterilisation be reversed?
A: Although there are procedures to reverse both male and female sterilisation, the process is not always successful. It isn’t normally available on the NHS and if paid for privately can cost several thousand pounds. This is why it’s so important to imagine all possible directions life may take and be certain that the person considering the sterilisation will not want to have children in the future, whatever happens.
Q. I thought a general anaesthetic wasn’t to be used in PH?
Yes, you’re right. Normally a general anaesthetic wouldn’t be advised as it’s not worth the higher risk it carries with PH. But there are times sterilisation under a general anaesthetic could be considered, such as if the anaesthetic is required for another intervention like abdominal surgery.
Q. I have heard a lot of men have problems with erections and ejaculation after male sterilisation. Is this true?
Male sterilisation only involves the small tube carrying sperm from the testicles to the penis. It does not affect any of the anatomy related to having and maintaining erections or ejaculating. It also does not have any effect on the man’s hormones. So having a male sterilisation has no effect on the ability of the man to have sex or on the man’s sex drive