Female Sterilization

Produced by Family Health Service of Department of Health and Hospital Authority

What is Female Sterilization?

Female sterilization is a permanent form of contraception. It involves a minor operation to cut or to block the Fallopian tubes on both sides of the uterus. Methods of female sterilization includes

  1. Postpartum sterilization
  2. Laparoscopic sterilization
  3. Minilaparotomy and bilateral tubal ligation
  4. Vaginal tubal sterilization.

What is postpartum sterilization?

  • Postpartum sterilization involves getting your tubes tied within the first few days after delivery.
  • Because the uterus is still enlarged at that time, a small incision (usually 2-3 cm) can be made under the umbilicus and the tubes can be tied, cut and a portion to be removed.
  • The entire procedure takes 10-20 minutes and can be carried out under general anaesthesia or local anaesthesia.
  • If you have a Caesarean section, your tubes may also be tied and cut during the same operation.

What is laparoscopic sterilization?

  • Laparoscopic tubal ligation involves introduction of a laparoscope (a pencil-like instrument with a small camera to be attached at the end) through a small incision under the umbilicus.
  • Another small incision (about 1 cm) at the lower abdomen is made to apply clips or rings to occlude the Fallopian tubes.
  • The operation is usually done under general anaesthesia and you can be discharged from the hospital on the same day (Day Surgery) or on the next day.
  • This is the preferred operation because the wound is smaller and thus you will feel less painful and have faster recovery.

What is minilaparotomy?

  • Minilaparotomy involves making an incision approximately 3 to 5 cm long at the lower abdomen and removing a portion of both Fallopian tubes as described in postpartum sterilization.
  • The operation can be done under general anaesthesia or local anaesthesia. Removal of stitches is usually required after 5 days.
  • Hospital stay is variable but tends to be longer than laparoscopic operation.

What is vaginal tubal ligation?

  • Vaginal tubal sterilization involves making a small incision in the vagina and removing a portion of both Fallopian tubes through it.
  • There will be no abdominal scar.
  • The operation is done under local anaesthesia.
  • You can be discharged immediately after the operation.
  • During the operative procedure you need to adopt a kneeling position.
  • To use this method, you should not be overweight.

Are there any other benefits of sterilization?

Apart from being a form of reliable permanent contraception, several potential benefits of tubal ligation have been suggested in the medical literature. These include a potential decrease in ovarian cancer as well as a decrease in pelvic inflammatory disease, i.e. an infection of the abdominal and pelvic cavity.

Will the operation fail?

  • For any types of tubal sterilization as mentioned above, in every 1000 women who have operation, 2 to 3 of them may still get pregnant.
  • Should pregnancy occur after tubal sterilization, the risk of having an ectopic pregnancy will be higher. This can be a life-threatening situation without prompt treatment.

If at any point after tubal sterilization you think that you may be pregnant, i.e. when you have missed period, and/or have vaginal bleeding and/or feel pain over the tummy, a pregnancy test should be checked immediately. If your pregnancy test is positive, contact your obstetrician as soon as possible to exclude ectopic pregnancy.

(Published 01/2006)