Surgical sterilization is a safe, highly effective, permanent, and convenient form of contraception. Numerous methods for achieving permanent sterilization have been described, and subsequently modified to improve success rates, simplify surgical technique and reduce postoperative pain and length of hospital stay. Laparoscopic techniques are preferred for most patients, as they are effective, and are usually performed on an outpatient basis, and result in rapid patient recovery. In 1995, almost 30 percent of contraceptive users in the United States used tubal sterilization .
Female surgical sterilization via laparoscopy or laparotomy is reviewed in this topic. Hysteroscopic sterilization is reviewed separately. (See "Hysteroscopic sterilization".)
Tubal sterilization is an elective and essentially permanent procedure. There are virtually no absolute contraindications, although a patient's gynecologic disease may require sterilization by hysterectomy and bilateral oophorectomy.
●Known extensive intra-abdominal adhesions increase the potential for intraoperative morbidity during laparoscopy. With the development of transcervical (or hysteroscopic) sterilization, laparotomy is now rarely necessary for sterilization. Alternatively, other forms of contraceptive can be offered. (See "Hysteroscopic sterilization" and "Overview of contraception".)
●Pregnancy may pose a significant risk to women with some medical disorders; thus forming a basis for elective sterilization. However, consultation with a maternal-fetal medicine specialist is advisable to determine the current magnitude of risk to mother and offspring, since occasionally women have been told that pregnancy is contraindicated when, in fact, it is not.