Contraception forever. Female voluntary sterilization
In previous issues of magazines, we talked about methods of contraception, which are reversible, because after the termination of their use, reproductive function and possibly the onset of pregnancy are restored. In this issue we will talk about the irreversible method of contraception in women – voluntary surgical sterilization.
Gynecologist-endocrinologist, Cand. honey. Sciences, Tyumen
Voluntary surgical sterilization (DXS), or as it is also called tubal occlusion – is a method of contraception, in which the obstruction of the fallopian tubes is artificially created and irreversible termination of the female reproductive function takes place. Currently, DXS is a common method of birth control in many countries of the world.
During the operation, the fallopian tubes are bandaged, crossed or clamped (brackets, rings) on them. Cauterization by electric shock is also possible. After this procedure, the meeting of the egg and spermatozoon is prevented because of the obstruction created artificially on their way.
The contraceptive effect is achieved immediately after surgery.
Before the operation, the patient is examined: gynecological examination, taking swabs from the vagina and cervix to determine the microbial flora, as well as the exclusion of cancer, ultrasound (ultrasound) of pelvic organs to exclude pregnancy and tumor processes of the uterus and ovaries; electrocardiogram (ECG); general analysis of blood and urine; blood chemistry; blood tests for syphilis, AIDS, hepatitis B and C; examination of the therapist. As a result of the examination, all possible contraindications to the operation are identified.
If they are identified, a conclusion is made about the feasibility and / or feasibility of using another reliable method of contraception.
By doing laparotomy The surgeon produces an incision (about 20 cm) that provides access to the organs on which the operation is performed. In this case, tissues are injured, there is pain after the operation, the healing period of the wound takes quite a long time, the scar can be significant.
After open surgical intervention in the abdominal cavity complications are possible and pronounced adhesions are formed (proliferation of connective tissue in the form of strands). Laparoscopic technique eliminates the need to make large incisions. The surgeon performs 3-4 skin incisions (about 1 cm), then a special hollow instrument produces punctures of soft tissues and inserts the instruments necessary for laparoscopic surgery and an optical device with a mini-video camera – a laparoscope; the image is transferred to the monitor screen, the surgeon sees internal organs and all manipulations are carried out under the control of vision.
It is obligatory to inflate the abdominal cavity with carbon dioxide, as a result of which the abdominal wall is raised and the best access to internal organs is provided. After the operation, the patient experiences less pain, there are scar marks on the skin, recovery of normal vital activity occurs faster, less complications, and the formation of adhesions in the abdominal cavity is minimized. Laparotomy is performed for medical reasons or during cesarean section, gynecological surgery for another matter, for free.
Laparoscopy is always done for a fee. At the expressed obesity at the patient laparoscopic technique is not applied for carrying out of operations on an abdominal cavity. In addition, when the abdominal cavity is inflated with carbon dioxide, there is a risk of gas bubbles entering the blood vessels, which can lead to gas embolism-the clogging of a large vessel with a similar bubble and impaired blood circulation in tissues and organs.
In the worst case, this leads to a lethal outcome. Sterilization is carried out only in a hospital under general anesthesia.
The duration of the operation is 15-20 minutes. Extract from the hospital, in the absence of complications, is performed depending on the technique for 2-3 (with laparoscopy) or 7-10th day (with laparotomy), respectively.
The rehabilitation period is up to 7 days or up to 1 month.
- High efficiency (0.01 pregnancies per 100 women).
- A quick effect, the procedure is carried out once.
- Constant method of contraception.
- No effect on breastfeeding.
- Lack of communication with sexual intercourse.
- Suitable for patients for whom pregnancy is a serious danger (for example, heart disease, chronic active hepatitis with signs of liver failure, a single kidney, the presence of malignant neoplasms of any location, repeated cesarean section in the presence of children, etc.).
- No long-term side effects.
- Does not reduce sexual desire.