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Permanent Methods of Sterilization
Tubal Ligation Vs. Vasectomy

By Tracee Cornforth, About.com

Updated November 08, 2009

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

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Many times when couples decide they don't want more children, or that children are not a part of their future, they decide that one of them will undergo permanent surgical sterilization. Permanent sterilization is the most effective method of contraception. Although tubal ligation and vasectomy can sometimes be reversed, both procedures should be considered a permanent end to your ability to have children.

One of the first things to decide is which partner will undergo permanent sterilization. Women have the option of having a tubal ligation, while men may choose to have a vasectomy performed.

The most common method of permanent sterilization is tubal ligation. However, this may be due to the fact that many couples don't realize that vasectomy involves far less risk to men than the risks associated with tubal ligation for women. In fact, vasectomy is usually performed in the physician's office rather than the hospital setting required for tubal ligation.

How do you decide who will undergo surgical sterilization? Educate yourselves about both the tubal ligation and vasectomy procedures. Learn what happens during each procedure. Find out about recovery from both methods of permanent sterilization. Ask about possible complications and / or any long-term consequences associated with either tubal ligation and vasectomy. Is one procedure more effective than the other? Once you're armed with the answers to these questions then you and your partner can make an educated decision that leaves both of you feeling comfortable with your choice.

Tubal Ligation or Vasectomy?

  • Vasectomy is a 30 minute procedure performed in the physician's office. Tubal ligation is performed in a hospital setting, most often on a day surgery unit.

  • Vasectomy requires two small incisions in the scrotum performed under local anesthetic; tubal ligation involves a small abdominal incision usually performed under general anesthesia. Occasionally, surgeons will perform tubal ligation under local anesthetic, however, this option is rarely instituted.

  • Vasectomy involves the cutting of the tubes (vas deferens) that carry sperm. The vas deferens are then sealed using either sutures or surgical clips on the end of each of the tubes. On the other hand, tubal ligation permanently ends the possibility of pregnancy by one of several methods; these methods typically involve cutting the fallopian tubes and then sealing them or clipping them so that sperm and egg cannot meet. You may have heard people say they had their "tubes tied," however, actually tying fallopian tubes is an antiquated method of tubal ligation that is no longer done by today's gynecologists.

  • Recovery from vasectomy usually requires only that the patient refrain from heavy physical activity for approximately 48 hours; tubal ligation requires women to limit physical activity and heavy lifting for at least one week following surgery.

  • Complications from vasectomy are relatively rare but can involve bleeding and infection, swelling of the scrotum, as well as the possibility of sperm granulomas (small, inflamed hard nodules at the end of the severed tube)--these usually heal on their own, however in some cases additional surgery may be required. Potential complications from tubal ligation include a slight risk of bleeding and infection.

  • The failure rate for vasectomy is about 1 percent. The failure rate for tubal ligation is slightly higher at about 2 percent which translates into a risk of pregnancy occurring following tubal ligation of about 1 pregnancy in 1000 women who've undergone this procedure.

    Long Term Health Risks

    Studies on the potential long term health risks to men who have undergone vasectomy remain inconclusive. However some believe the risk of future prostate cancer is increased. Research indicates that fears of increased risk of heart disease and testicular cancer appear to be unfounded. A 1993 report issued by the National Institutes of Health recommended that further study be conducted on the potential long-term health risk of vasectomy. However, changes in vasectomy procedure were not recommended in the report. This tends to lead many to believe that the actual risk of prostate cancer attributable to vasectomy is extremely low or non-existent.

    Women who chose tubal ligation often experience changes in their menstrual cycle. Possible menstrual changes of attributed to tubal ligation include pelvic pain, and additional surgery, although whether either of these complications are true remains a subject of controversy among physicians. Although controversial, some women say they experience a condition calledpost tubal ligation syndrome following tubal ligation. According to studies, women who undergo tubal ligation before age 30 face a significantly higher risk of having a hysterectomy. Other research suggests that tubal ligation may provide protection against ovarian cancer and pelvic inflammatory disease (PID).

    Next: Affect on Sexual Desire

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