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10.0 Surgical Sterilization

10.1 Method

Female sterilization

It is a surgical procedure involving ligation of both the fallopian tubes. This method results in permanent cessation of woman’s ability to procreate.


Male sterilization

This is surgical procedure involving bilateral vas ligation in males. It is used as a permanent method of birth control.

10.2 Timings

Female sterilization

• immediately after childbirth and up to 7 days (minilap)

• 6 weeks after childbirth (laparoscopic ligation)

• immediately after spontaneous or induced abortion (aseptic)

• any time during menstrual cycle if pregnancy is ruled out and the woman is not having sex without contraception

Male sterilization

• this can be done at any time

10.3 Efficacy of sterilization


Table III Failure rates during the first year9

 Sterilization %of women with pregnancy
lowest expected typical
Female 0.2 0.4
Male 0.1 0.15


10.4 Contraindications and Special Precautions

There is no medical condition that would absolutely restrict a person’s eligibility for sterilizations. In certain conditions, precautions should be taken.

10.4.1 Clinical conditions which warrant that procedure should be delayed until the condition is evaluated and/or corrected

Female sterilization

• severe pre-eclampsia or eclampsia

• history of prolonged rupture of membranes > 24 hours

• puerperal sepsis

• history of severe trauma to the genital tract, cervical or vaginal tear during delivery

• current DVT/PE

• major surgery with prolonged immobilization

• current ischaemic heart disease

• unexplained vaginal bleeding

• suspected genital tract malignancy

• PID - current or within last 3 months

• iron deficiency anaemia Hb < 8 gm%

• abdominal skin infection

• sterilization concurrent with abdominal surgery for some infectious diseases without prior counseling

Male sterilization

• local infections

• scrotal skin infection, active STI, epididymitis or systemic infection

• filariasis, elephantiasis

• intra-scrotal mass

10.4.2 Special conditions where experienced surgeon and staff is required alongwith a setting equipped for general anaesthesia and other medical support

Female sterilization

• chronic hypertension with BP > 160/100

• vascular or complicated valvular heart disease

• endometriosis


• pelvic tuberculosis

• diabetes with complications

• hyperthyroidism

• co-agulation disorder

• respiratory diseases

• dense pelvic adhesions suspected

• abdominal wall or umbilical hernia

Male sterilization

• Inguinal hernia

• Co-agulation disorder


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