Procedures / Operations

Female sterilization procedures

For women whose family is complete and who no longer wish to use reversible forms of contraception such as the pill or an IUD, a number of options exist for permanent sterilization. In the past, the most common form of female permanent sterilization was a laparoscopic tubal ligation.

  • This technique uses a keyhole incision to pass a camera (laparoscope) through the umbilicus  and pass CO2 into the abdomen. The fallopian tubes are viewed and a clip of plastic and titanium placed across each tube. The technique has a quoted failure rate (pregnancies) of 1:300-500 and causes a mild abdominal pain for up to a week post-op. There are risks of laparoscopy which would all be explained, and whilst the clips can be removed at a later stage, it should be thought of as a permanent procedure.
  • Non-incisional methods – 2 techniques exist for sterilization using the natural orifice of the cervix to pass a camera. This involves no cuts and hence recovery is quicker and pain minimal. The Essure procedure ( involves placing 2 tiny coils of Nickel titanium in the fallopian tubes which cause them to block over the next 3 months. There is minimal discomfort and it can be performed without anaesthesia if desired, although most women choose to have a very quick anaesthetic. The entire procedure usually lasts less than 10 minutes and 90% of woman return to normal activities within 24 hours. The Adiana procedure involves a similar approach through the cervix with compatible results placing a small Silicone plug into each tube.

Dr Rosen was involved in the first stages of introducing hysteroscopic sterilization worldwide. In 2000 he was an investigator in the trials to show the effectiveness of the updated device, and spent 2001-2 travelling around this country training his fellow gynaecologists in the technique of inserting the device, as well as lecturing and demonstrating the procedure in Asia and Europe. He is skilled in all methods above and would be happy to discuss the risks and benefits of each technique as well as comparing them to male sterilization (vasectomy).

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