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Definition

Hysteroscopic sterilization provides a permanent form of birth control for women. It blocks the fallopian tubes which allow eggs to pass from the ovaries to the uterus. A device is placed in the fallopian tubes. It makes tissue grow which will then block the tubes. This will keep the sperm from reaching eggs.

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Reasons for Procedure

Hysteroscopic sterilization is done to prevent pregnancy. It does not stop periods. It does not protect from sexually transmitted diseases.

This procedure is only an option for those that want a permanent birth control. Other birth control options are a better choice for those who may want a future pregnancy. The doctor will discuss all birth control options before a this procedure.

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Improper placement or slipping of device
  • Tubes are not completely blocked
  • Injury to the uterus or fallopian tubes
  • Rupture of fallopian tube during the procedure
  • Chronic pain
  • Unintended or ectopic pregnancy

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as:

  • Smoking
  • Drinking
  • Chronic disease, such as diabetes or obesity

What to Expect

Prior to Procedure

A physical exam will be done. Since the device is permanent, your doctor may advise counseling. The best time for the procedure is after the end of your menstrual cycle.

Anesthesia

You may be given local anesthesia. It will block any pain. Sedation medicine may be used to ease anxiety.

Description of the Procedure

This may be done in a doctor’s office or operating room. A soft, flexible tube will be passed through the vagina to the uterus and fallopian tubes. It will let the doctor view the area. The devices will placed into each of the fallopian tubes. Once they are in place the scope is removed.

The inserted devices are made with nickel. It stimulates the growth of tissue. After about 3 months, there is often enough scar tissue to block the fallopian tubes.

How Long Will It Take?

About 10 minutes

Will It Hurt?

There may be some discomfort and pressure during the procedure. You may have some cramping after the procedure. Medicine may help.

Post-procedure Care

At the Doctor’s Office

You will be monitored after the procedure is done. It may be up to 45 minutes before you can leave. If there are complications, this time may be longer.

At Home

The device takes about 3 months to be effective. During this time, continue use of other birth control methods. Follow up appointments will be needed. The doctor will do imaging test to make sure that the fallopian tubes are closed off.

Most will return to normal activity in 1 to 2 days. Common side effects include:

  • Mild cramping
  • Pelvic discomfort
  • Nausea and/or vomiting
  • Vaginal bleeding

Call Your Doctor

It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:

  • The device falls out
  • Signs of infection, including fever or chills
  • Pain or bleeding that lasts longer than you or your doctor expect
  • Excessive vaginal bleeding
  • New or worsening symptoms

If you think you have an emergency, call for medical help right away.

RESOURCES:

The American Congress of Obstetricians and Gynecologists
http://www.acog.org

Women's Health—US Department of Health and Human Services
http://www.womenshealth.gov

CANADIAN RESOURCES:

The Society of Obstetricians and Gynaecologists of Canada
http://sogc.org

Women’s Health Matters
http://www.womenshealthmatters.ca

REFERENCES:

American College of Obstetricians and Gynecologists. ACOG Practice bulletin no. 133: benefits and risks of sterilization. Obstet Gynecol. 2013 Feb;121(2 Pt 1):392-404.

Hysteroscopic sterilization. The American College of Obstetricians and Gynecologists. Available at: http://www.acog.org/Patients/FAQs/Hysteroscopic-Sterilization. Updated April 2017. Accessed January 11, 2019.

Lessard CR, Hopkins MR. Efficacy, safety, and patient acceptability of the Essure procedure. Patient Prefer Adherence. 2011;5:207-212.

Tubal sterilization. EBSCO DynaMed Plus website. Available at:https://www.dynamed.com/topics/dmp~AN~T115331/Tubal-sterilization. Updated August 28, 2018. Accessed January 11, 2019.

Last reviewed November 2018 by Beverly Siegal, MD, FACOG  Last Updated: 1/8/2019