Laparoscopic Sterilisation

Almost any woman can be sterilised, but it should only be considered if you do not want any more children or do not want children at all. You may be more likely to be accepted for the operation if you’re over 30 and have had children.

• More than 99% effective at preventing pregnancy.
• Blocking the fallopian tubes should be effective immediately (but contraception should be used until your next period)
• It will not affect your sex drive or interfere with sex.
• It will not affect your hormone levels (you will still have periods).

• It does not protect against STIs, so you should consider using condoms.
• It cannot be easily reversed, and reversal operations are rarely funded by the NHS.
• It can fail (the fallopian tubes can rejoin and make you fertile again, although this is rare).
• There is a very small risk of complication, including internal bleeding, infection or damage to other organs.
• If you get pregnant after the operation, there is an increased risk it will be an ectopic pregnancy.

• Sterilisation reversal is not usually available on the NHS.
• Success rates vary and depend on factors like age and the method used in the original operation.
• It is possible to have a sterilisation reversal done privately but it is expensive (several thousand pounds).
• There is no guarantee that you will be able to get pregnant after a sterilisation reversal.

You can get more information on sterilisation from:
• Your GP.
• Contraception clinics.
• Sexual health or genitourinary medicine (GUM) clinics.
• Some young people’s services.

Your GP may recommend counselling before referring you for sterilisation as this will give you a chance to talk about the operation in detail and discuss any doubts, worries or questions you may have. Your GP can refuse to refer you for it, if they do not believe it is in your best interests.

If you have a partner, discuss it with them before you decide. If possible, you should both agree to the procedure, but it is not a legal requirement to get your partner’s permission.

If the GP agrees with your decision, they will refer you to a gynaecologist for treatment at your nearest NHS hospital. You can choose Tetbury Hospital Trust as your preferred hospital.

After your first consultation, you will be assessed either by telephone or in our pre-admission clinic to make the final arrangements and to check if you are fit for surgery. We will organise a routine blood test for you two to three days prior to your admission to ensure we have a blood match saved for you in case of an emergency. Without this we are unable to perform the procedure.

Pregnancy. If you are taking the contraceptive pill, there is no need to stop as the surgery is only a day case procedure. Please avoid unprotected intercourse during the month of your laparoscopy as if there is any chance of you being pregnant your operation will be cancelled. We will carry out a pregnancy test on the day of the operation to check there is no risk. You will need to use contraception right up until your next period after surgery.

Sterilisation can be performed at any stage in your menstrual cycle

The procedure is usually done as day surgery so you will come into hospital in the morning and be allowed to go home approximately four hours after.

You will come into the unit having eaten nothing for six hours and you will only be allowed clear fluids for the two to six hours before your procedure. After you have been admitted, the consultant gynaecologist and anaesthetist will come and answer any questions you may have and ask you to complete and sign a consent form. A pregnancy test will be performed.

The operation takes about 15 minutes.

You will be given a general anaesthetic, and when you are asleep, the surgeon will make a small 1cm long cut under the navel and one or two smaller cuts just above the pubic hairline. Some medical gas is put into your abdomen so that the surgeon has a better view when the laparoscope (telescope) is inserted through the first small cut. Through this, the surgeon can inspect your womb and fallopian tubes and apply the clips. To assist the inspection and for treatment, it may be necessary to insert further instruments through the other cuts. At the end of the operation the medical gas will be released, and the small cuts closed using an absorbable stitch or surgical glue.

You will be allowed home once you have recovered from the anaesthetic, been to the toilet and eaten something light. Our medical support team will tell you what to expect and how to care for yourself after surgery and will give you a contact number to call if you have any problems or questions.

Because you have had a general anaesthetic you will need a responsible adult to take you home and be with you for 24 hours.

Do not drive a car for 24 hours afterwards. Even if you feel fine, your reaction times and judgement may not be back to normal.

After the operation you may have a sore throat or feel sick from the anaesthetic and you may need to rest for a few days.

Paracetamol and ibuprofen are recommended for the first couple of days, with codeine (if appropriate) supplied by the hospital for any breakthrough pain. Do not exceed the recommended maximum daily dose.

You may have some vaginal bleeding following the operation. Tampons may be used. If pain or bleeding becomes excessive you should contact your GP for advice.

You may also experience discomfort around the shoulders because of the medical gas used to distend the abdomen and protect the internal organs. It creates pressure on the abdominal nerve, which is connected to the shoulder area. Changing your position may help with the pain but it will gradually disperse over a couple of days. Regular painkillers will help.

You may have a shower the day after your surgery. You will have waterproof dressings over your wounds and please keep these on until stitches are removed. You may have some slight vaginal bleeding.

You may also feel some pain, like period pain; painkillers such as paracetamol and ibuprofen will help. If the pain or bleeding gets worse, contact the specialist who treated you, your GP or dial 111.

You will have a wound with stitches or surgical glue, where the surgeon made the cuts. The glue will dissolve and fall off over the next couple of weeks. Do not peel it off.

Please make an appointment with the practice nurse at your GP’s surgery to remove the stitches 10 days post operation. Although they are dissolvable, they can become infected if left in for too long.

• Your sex drive and sex life should not be affected. You can have sex as soon as it is comfortable to do so after the operation.
• Use additional contraception until your first period to protect against pregnancy.
• Sterilisation does not protect against sexually transmitted infections (STIs), so you may need to use condoms.

Depending on your general health and job, you can normally return to work five days after tubal occlusion but avoid heavy lifting for about a week.

While most women recover well after a laparoscopy, complications can occur. You should call the Tetbury Hospital switchboard between 08:30 to 16:30, Monday to Friday on 01666 502336, or outside these hours seek medical advice from your GP or dial 111 if you experience:
• Burning and stinging when you pass urine or pass urine frequently. This may be due to a urine infection which can be treated with a course of antibiotics.
• Red and painful skin around your scars. This may be due to a wound infection which can be treated with a course of antibiotics.
• Increasing abdominal pain. If you also have a temperature, have lost your appetite and are vomiting, this may be due to damage to your bowel or bladder, in which case you will need to be admitted to hospital.
• A painful, red, swollen, hot leg or difficulty bearing weight on your legs. This may be due to a deep vein thrombosis (DVT). If you have shortness of breath or chest pain or cough up blood, it could be a sign that a blood clot has travelled to the lungs (pulmonary embolism). If you have these symptoms, you should dial 999 immediately.
• There is no improvement in your symptoms. You should expect a gradual improvement in your symptoms over time. If this is not the case, call the Tetbury Hospital switchboard between 08:30 to 16:30, Monday to Friday on 01666 502336.