Permanent family planning methods used to require moderately invasive surgery for the woman or the man. These procedures became less invasive through the use of laparoscopic surgical methods. Then new methods became available for women using hysteroscopic office procedures, making recovery times shorter and the procedure less painful.
Types
Men can get a vasectomy, which involves laparoscopically cutting the two vas deferens tubes so that the sperm can no longer reach the semen. According to Family Doctor, this can be done as an office procedure under local anesthesia.
Women have the choice of getting a tubal ligation done laparoscopically, which involves cutting, blocking or tying the Fallopian tubes, or getting the Adiana or Essure devices inserted hysteroscopically using a tube with a camera on the end. They also have the option of having a complete hysterectomy, which is the most radical option but the only one that is 100 percent permanent and effective.
Features
All permanent family planning methods can be done as outpatient procedures and take only about 30 minutes to perform. Recovery times are short, with people being able to resume normal activities within the same day for Adiana and Essure, within a week for tubal ligation and within two weeks for vasectomies.
According to a 2009 article in "Reviews in Obstetrics and Gynecology" by Sophia N. Palmer, MD, Essure is the most effective method for permanent family planning, besides a hysterectomy, with a failure rate of less than 1 percent, and Adiana is less effective, with a failure rate between 1 percent and 2 percent.
Considerations
It takes time for these procedures to be fully effective, with vasectomies, Adiana and Essure all taking three months or longer and requiring a second visit to the doctor to confirm their effectiveness.
With Adiana and Essure, proper placement is important, as is follow-up. Most failures can be attributed to improper placement, the patient not obeying instructions for using other birth control until follow-up shows that the tubes are fully occluded, or the doctor incorrectly reading the X-ray done to verify occlusion, according to Palmer.
Those who have a hysterectomy will no longer have periods. However, if the ovaries are also removed they will go into menopause after the surgery, with all the accompanying side effects.
Warning
In some cases, women will still get pregnant after these methods have been put into place. This can be from to the tubes growing back together after a vasectomy or tubal ligation, the pregnancy already being present before the procedure or the Adiana or Essure devices not fully blocking the Fallopian tubes. A hysterectomy is the only way to guarantee you will not get pregnant.
Expert Insight
Although in some cases it is possible to reverse permanent family planning methods, they should be considered permanent. A reversal is not always effective, and it is very expensive, according to the Center for Health Training. Those who do not have children, who are very young or who are in unstable relationships are most likely to regret having the procedure, the center says.
References
- Center for Health Training: Tubal Ligation: Female Sterilization
- Family Doctor: Vasectomy: What to Expect
- Reviews in Obstetrics and Gynecology: Transcervical Sterilization: A Comparison of Essure Permanent Birth Control System and Adiana Permanent Contraception System
- Mayo Clinic: Adiana
- Mayo Clinic: Essure
