Male and female sterilization lecture
After a vaginal delivery, the bottom of the uterus is still high near the navel, easy sterilization technique, does not prolong the hospital stay
Surgical contraception can be used for women or for men. Up to now, in general, sterilization is still considered as a permanent, irreversible contraceptive method, it is necessary to grasp this issue well and conduct full counselling for couples when sterilization is required. They know for sure that teeth cannot be reproduced after sterilization.
The principle of female sterilization is to interrupt the two ovaries, leading to the failure of the ovary to meet the sperm, the phenomenon of fertilization does not occur.
Time of sterilization
During caesarean section, sterilization for medical reasons (severe chronic disease, genital tract damage ...).
After vaginal delivery, the bottom of the uterus is still high near the navel, easy sterilization technique, does not prolong the hospital stay. Sterilization should be carried out within 72 hours after birth to limit upstream infection in the oviduct. Postpartum sterilization has a number of limitations such as: postpartum bleeding may occur, the child's health is uncertain ...
Sterilization after abortion, abortion. Should only conduct sterilization when making sure that there are no fetuses and vegetables.
Sterilization in a normal cycle, it is best to carry out the procedure in the first half of the cycle, to ensure the client is not pregnant.
Sterilization may To perform through
Normal abdominal opening (sterilization during cesarean section, ectopic surgery, ovarian tumor ...).
Minilap is used in the case of only two oviduct sterilization, the abdominal incision is about 3-4cm long. This method is often done when people conduct a sterilization campaign for a large number of customers in a particular match site.
Vaginal tract: Going through the same back of the vagina to reach the two tubes. Many surgeons are unfamiliar with this method. This method is not recommended when using sterilization for a large number of clients.
Through laparoscopy: the disadvantage of the method is the need to equip an endoscope system, a crew of surgeons who are proficient in laparoscopic surgery. This method is also not possible for the majority of customers in a campaign.
Through hysteroscopy, there are many methods of sterilization such as pumping silastic into the two ovaries, placing the device in the ovary (J. Hamou), using the YAG laser to destroy the interstitial part of the ovary (this method has a failure rate quite high, about 10-30%).
Two-hit sterilization techniques
The oviductal ligation techniques are usually done at the waist of the oviduct, about 2cm from the uterine horn, at the avascular space of the oviduct.
The simple Pomeroy method is most commonly used. Lift up one section of the oviduct, tie it together, and cut the portion of the newly lifted oviduct.
After the cut is complete, the other two oviduct ends are next to them like a double-barrel gun. A very important point is to use the target (catgut) to tie the oviduct. After this the target goes, the two ends of the oviduct are far apart. This is the most commonly applied method in our country today. There are also many other sterilization techniques such as Irving method, Parkland method, Madlener method, Kroener method.
Laparoscopic sterilization using Yoon (1973) Bleier clamp (1977), Hulka-Clemens clamp (Hulka -1973), Filshie clamp or heat burning, bipolar or monopole electric knife (bipolar knife is recommended has many advantages over unipolar electric knives).
The failure rate of some methods of endoscopic sterilization
Burning with a 3.5 / 1000 monopole.
Burn with a 1.1 / 1000 bipolar knife.
Heat incineration 0.21 / 1000.
Yoon round 1-16 / 1000.
Hulka Cup <5/1000.
Pilshie clamp 0.9-4.9 / 1000.
Although it is possible in recent years to re-implement the oviduct after micro-surgical sterilization, it must always be considered that female sterilization is a permanent method of contraception, contraception is not reversed. Pay attention to advise customers to understand this issue before deciding to use this service. Tubular reconnection results depend on the extent to which the oviduct has been damaged, with a general success rate of about 50% of the cases being reconnected.
The principle of male sterilization is to cut two vas deferens that carry sperm from the seminal vesicle to the ejaculation tube. After a vasectomy, when there is ejaculation, the semen no longer contains sperm in it.
Male sterilization by using two vasectomy. The current popular method is the method without tools, proposed by Li Shun-Qưiang in China (1974). The procedure is quick, the patient can go home immediately. Compared with female sterilization, male sterilization is less dangerous, less complications, and cheaper. The cost for male sterilization is only 1/4 of that of female sterilization. The downside of male sterilization is that the effect of sterilization does not appear immediately.
After the vasectomy has to wait 12 weeks or have to ejaculate 15-20 times for the sperm at the end of the vas deferens to drain out to have contraceptive effects. So during this time another temporary measure must be used. The failure rate of male sterilization is about 1% (1975).
Advantages and disadvantages of sterilization
U u Point
A highly effective method of contraception, customers can rest assured, no longer wonder about using contraception.
The economic efficiency of this method is very high, a "irreversible" method of contraception, a method of permanent contraception.
There is no risk of unwanted, side effects.
Completely does not affect intercourse, does not affect libido, pleasure. It even increases the need for sex because there is no need to worry about unwanted pregnancy.
As a surgical intervention, even though it is minor, there are risks of surgery: infection, the risk of anaesthesia and pain relief ...
It is necessary to have a team of well-trained medical staff, which requires certain equipment.
Always regarded as an irreversible contraceptive.
Currently, there are many effective contraceptive methods with few unwanted effects and acceptable costs. Many countries and many political organizations have tried to widely apply contraception to control population growth. On the part of the client, the client has the right to have sufficient information, the right to access and the freedom to choose the right contraceptive method.