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When it comes time for a couple to discuss the issue of permanent sterilization, the risks and
benefits of tubal ligation (for the female partner) verses vasectomy (for the male partner) are
an important consideration. Certainly in past years tubal ligation has been more popular than
vasectomy in North America. By comparing the important characteristics about each, the reasons
behind the shifting trends in favor of vasectomy, become evident.
In skilled hands vasectomy has a failure rate approximately equal to tubal ligation - somewhere
between 1/200 and 1/500. The success of a vasectomy can be confirmed by doing semen checks. The
success of a tubal ligation cannot be confirmed by any conventional testing (except an unwanted
pregnancy). After a vasectomy has been confirmed successful, there remains a small risk of
failure over the next 10 years – judged to equal approximately 1 in 3000*. The risk of failure
for tubal ligation increases with the amount of time. The chances of successful procedure are
approximately 1 in 500 to 1 in 200, (dependant upon surgeon) and while the woman remains fertile,
the risks increase approximately two-fold. If a vasectomy fails the couple may have to deal with
the pregnancy. If tubal ligation fails the most common site of a pregnancy is what is termed an
“ectopic pregnancy”. This is a pregnancy in a place other than in the uterus where it supposed
to occur (i.e. the fallopian tubes or elsewhere). Surgery is often required to extract the
non-viable embryo usually at great risk to the mother.
Vasectomy is a simple straightforward operation. It can be done in a doctor’s office using local
anesthetic. Tubal ligation must be done in a hospital using general anesthetic which carries
higher risks. Therefore, surgical risks in vasectomy are also considered much less than with
tubal ligation. In fact death resulting from a vasectomy is virtually unheard of. Complications
can occur from vasectomy like scrotal hematoma (i.e. a large blood filled scrotum) that takes
months to resolve or chronic pain syndrome, which may take months or years to resolve. Serious
complications from tubal ligation that can be life threatening occur with a higher frequency.
For example bowel or major vessel rupture occurs approximately 1 in 1000 times with tubal
ligation. Though very uncommon, complications following tubal ligation can also lead to death.
In summary as couples become more educated regarding the benefits and risks of these two
procedures and men become more sensitive and responsible to the responsibilities incumbent
upon them in dealing with birth control, it is likely that the vasectomy will continue to
increase in popularity over tubal ligations.
References:
AUTHORS: Hendrix NW. Chauhan SP. Morrison JC
INSTITUTION: Spartanburg Regional Medical Center, South California, USA
TITLE: Sterilization and its consequences (Review) (67 refs)
SOURCE: Obstetrical and Gynecological Survey .54 (12):766-77, 1999 Dec.
AUTHOR: Wilson EW
INSTITUTION: World Health Organization, Paihia, New Zealand
TITLE: Sterilization (Review) (96 refs)
SOURCE: Baillieres Clinical Obstetrics and Gynaecology. 10 (1) 103-19, 1996 Apr.
*
To further elucidate
this risk, if 3000 couples were sexually active and
did so unprotected for 10 years, one pregnancy would result in the entire group
over that 10 year period.
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