Vasectomy

Vasectomy is a minor surgical procedure wherein the vasa deferentia of a man are severed, and then tied or sealed in a manner such to prevent sperm from entering the seminal stream

Types

Typically done in an outpatient setting, a traditional vasectomy involves numbing (local anesthetic) of the scrotum after which 1 (or 2) small incisions are made, allowing a surgeon to gain access to the vas deferens. The "tubes" are cut and sealed by tying, stitching, cauterization (burning), or otherwise clamped to prevent sperm from entering the seminal stream. Variations of the procedure have been explored/used in hopes of reducing recovery time and pain (in recovery and post-surgery). The "Vas-Clip" method does not require cutting the Vas Deferens, but rather uses a clip to squeeze shut the flow of sperm. This method claims reduced pain in recovery, but statistics suggest a lower overall success rate compared to traditional methods. The No-Scalpel method (coined Key-Hole),[2] in which a sharp hemostat, rather than a scalpel, is used to puncture the scrotum may reduce healing times as well as mitigate the chance of infection. An "open-ended" vasectomy obstructs (seals) only one end of the vas deferens, which allows continued streaming of sperm (by virtue of the un-sealed vas-deferens) into the scrotum. This method may avoid build-up of pressure in the epididymis. Testicular pain (from "backup pressure") may also be reduced using this method.

Tubal Ligation

Tubal ligation is a permanent form of female sterilization, in which the fallopian tubes are severed and sealed or "pinched shut", in order to prevent fertilization. Hormone production, libido, and the menstrual cycle can be affected by a tubal ligation.

A tubal ligation surgery can be done in many forms; through a vaginal approach, through laparoscopy, a minilaparotomy ("minilap"), or through regular laparotomy. Also, a distinction is made between postpartum tubal ligation and interval tubal ligation, the latter not being done after a recent delivery. There are a variety of tubal ligation techniques; the most noteworthy are the Pomeroy type that was described by Ralph Pomeroy in 1930, the Falope ring that can easily be applied via laparoscopy, and tubal cauterization done usually via laparoscopy. In addition, a bilateral salpingectomy is effective as a tubal ligation procedure. A tubal ligation can be performed as a secondary procedure when a laparotomy is done; i.e. a cesarean section. Any of these procedures may be referred to as having one's "tubes tied."

Tubal ligation can be performed under either general anesthesia or local anesthesia . The default in tubal ligations following on from cesarean birth is usually spinal/epidural, while the default in non-childbirth related situations may be general anesthesia as a matter of doctor preference. However, tubal ligations under local anesthesia, either inpatient or outpatient, may be performed under patient request.

Less commonly performed is the Essure procedure, in use since 2002. In this procedure micro-inserts are placed within the fallopian tubes by means of catheter and Hysteroscopy. The micro-inserts produce eventual occlusion of the fallopian tubes by causing the in-growth of tissue.