Sterilization (surgical procedure)

Categories: Andrology | Birth control | Medicine stubs

For the process of removing or killing all microorganisms from an object, see Sterilization (microbiology).

Sterilization is a surgical technique leaving a male or female unable to procreate. It is a method of birth control.

A vasectomy in males. The vasa deferentia, the tubes which connect the testicles to the prostate, are cut and closed. This prevents sperm produced in the testicles to be in the ejaculated semen fluid (which is mostly produced in the prostate and the seminal vesicles).
A tubal ligation in females. The Fallopian tubes, which allow the sperm to fertilize the ovum and would carry the fertilized ovum to the uterus, are closed. This is sometimes referred to as getting one's "tubes tied."
A hysterectomy in females. The uterus is surgically removed, permanently preventing pregnancy and some diseases, such as uterine cancer.

The closing of either type of tube can be done in several different ways, some of which are more permanent or guaranteed to work than others. The tube can be

clamped off
cut off
tied off
blocked

1 Vasectomy
- 1.1 Safety and effectiveness
- 1.2 Reversal
2 Sterilization of animals
3 See also
4 References
5 External links

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Vasectomy

Vasectomy should not be confused with castration: vasectomy does not involve removal of the testicles and it affects neither the production of male sex hormones (mainly testosterone) nor their secretion into the bloodstream. Therefore sexual desire (libido) and the ability to have an erection and an orgasm with an ejaculation are not often affected. Because the sperm itself makes up a very small proportion of the ejaculate, vasectomy does not affect the volume, appearance, texture or flavour of the ejaculate. Similarly, in females, hormone production, libido, and the menstrual cycle are not affected by a tubal ligation.

When the vasectomy is complete, sperm can no longer exit the body through the penis and it seems that they penetrate the blood-testes barrier. Normally, the barrier keeps the immune system separate from the reproductive system. When the barrier is compromised by vasectomy, injury, or even a simple puncture from a biopsy, the two systems interface. This usually results in the development of anti-sperm antibodies.

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Safety and effectiveness

Early failure rates of vasectomy are below 1%, but the effectiveness of the operation and rates of complications vary with the level of experience of the surgeon performing the operation and the surgical technique used. Early complications, including hematoma, infection, sperm granulomas, epididymitis-orchitis, and congestive epididymitis, occur in 1%–6% of men undergoing vasectomy. The incidence of epididymal pain is poorly documented. Animal and human data indicate that vasectomy does not increase atherosclerosis and that increases in circulating immune complexes after vasectomy are transient. The weight of the evidence regarding prostate and testicular cancer suggests that men with vasectomy are not at increased risk of these cancers.^[1]

Very few women later come to regret that their partner had a vasectomy, unless there is significant conflict with the partner before the operation.^[2]

Although late failure (caused by recanalization of the vasa deferentia) is very rare, it has been documented.^[3]

Vasectomy remains the most effective long-term contraceptive choice, and is among the safest options for family planning.

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Reversal

In order to allow for reproduction (via artificial insemination) after vasectomy, some men opt for cryostorage of sperm before sterilization. However, the long term viability of spermatozoa in cryostorage is questionable. Although there is a procedure to reverse vasectomies using vasovasostomy (a form of microsurgery), it is not effective in many cases, and men considering vasectomies should not think of them as reversible. Various temporary male contraceptives are being researched but not yet available, such as male oral contraceptives and the intra vas device. There has been at least one documented case of a vasectomy being reversed on a dog, which then fathered puppies after the reversal.

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Sterilization of animals

In animals, castration (removal of the testes) and salpingo-oophorectomy (removal of the ovaries and fallopian tubes), called neutering or spaying when applied to pets, are used to prevent conception, heat in females, and to potentially prolong an animal's lifespan. Animal control organizations have urged owners to have their pets spayed or neutered in order to prevent an increase in the population of stray animals. These stray animals are often malnourished and euthanized in pet shelters.

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References

^ Safety and effectiveness of vasectomy, Pamela J. Schwingl, Ph.D., and Harry A. Guess, M.D., Fertility and Sterility, 73 (5) May 2000
^ A Comparison of Women’s Regret After Vasectomy Versus Tubal Sterilization, Denise J. Jamieson et al, Obstetrics & Gynecology, 99 (6) June 2002
^ Late failure of vasectomy after two documented analyses showing azoospermic semen, Philp, T; Guillebaud et al, British Medical Journal (Clinical Research Ed.) 289 (6437) July 1984, Pages 77-79