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Vasectomy vs Tubal Ligation for Women

Vasectomy vs tubal ligation for womenVasectomy vs Tubal Ligation for Women

Vasectomy vs tubal ligation for women is the permanent birth control choice that faces many couples. Both of these sterilization procedures should be regarded as permanent, even though surgeons can perform vasectomy reversals and tubal ligation reversals.

Vasectomy vs Tubal Ligation for Women, What’s the Story?

A vasectomy is a surgical procedure that involves cutting the vas deferens, which is the tube that transports sperm. Once the vas deferens is cut, sperm cannot mix with semen, which in turn prevents a man from getting a woman pregnant.

A tubal ligation can be accomplished in two different ways. The traditional tubal ligation, also known as “having your tubes tied,” involves cauterizing or clamping the fallopian tubes to prevent pregnancy. A tubal ligation stops eggs from reaching the uterus for fertilization and sperm from traveling up the fallopian tubes to the eggs. The procedure can be done at any time, but many women choose to have it done immediately after childbirth or at the same time as abdominal surgery, including a caesarean section.

Two newer forms of tubal ligation include the Essure™ method and the less common Adiana™ procedure. Both are non-surgical techniques and are known as hysteroscopic sterilization. Basically, both methods involve using a catheter to place tiny inserts into the fallopian tubes. Although the two inserts are slightly different in structure, the principle under which they work is the same. During the three months after insertion, the body forma a natural barrier in the fallopian tubes, which prevents sperm from reaching the eggs. Essure and Adiana have lower risks and complications than traditional tubal ligation because they do not involve general anesthesia or incisions, which reduces the risk of infection and speeds up recovery.

For couples who are deciding between vasectomy vs tubal ligation for women, it is helpful to compare the procedures in terms of cost, risks and complications, and recovery. Overall, a vasectomy is safer, has a faster recovery period, a higher success rate, and is less expensive than tubal ligation. Here are some specifics.

Recovery Time for Vasectomy vs Tubal Ligation for Women

Recovery time for vasectomy is relatively short. Typically, men who have a vasectomy on a Thursday or Friday can return to work on Monday. Men can leave the doctor’s office nearly immediately after the procedure. They and should stay off their feet, elevate their legs, and use ice packs to control swelling and pain for the first few days after the vasectomy. Lifting heavy objects, sports, and vigorous exercise should be avoided for about a week. Baths, pools, and whirlpools should be avoided for at least 48 hours after surgery. Sexual intercourse can resume no sooner than 72 hours after a vasectomy.

After tubal ligation, women usually spend several hours or longer at the hospital if the surgery was done as part of another surgery. Symptoms typically last 2 to 4 days and include bloated stomach, shoulder pain, sore throat, and discharge or bleeding from the vagina. Women can usually resume normal activities after 2 or 3 days, but should avoid lifting anything heavy for 3 weeks.

After an Essureprocedure, women can return home immediately, and there are no activity restrictions. Women who have a traditional tubal ligation need to restrict their physical activities for a week or longer.

Time to Sterility after Vasectomy vs Tubal Ligation for Women

After a vasectomy, men are not sterile until they no longer have sperm in their semen. Semen samples are typically checked 12 weeks after a vasectomy,when men generally become sterile. If sperm are still present at that point, subsequent samples will be taken. Until sterility is confirmed, an alternative form of birth control should be used. The failure rate (unintended pregnancy) for vasectomy is 0.02% to 0.2%.

After a non-surgical tubal ligation (Essure or Adiana), a woman may still be fertile for about three months, which is the amount of time it takes for the body to form a barrier in the fallopian tubes. Women need to use another form of birth control during that time. After three months, an x-ray can determine if the fallopian tubes are fully blocked, which indicates sterility. The failure rate for Essure is 0.1% when the tubes are blocked. For Adiana, the failure rate is 1.1% at one year and 1.8% at 2 years.

Women who have a traditional tubal ligation are sterile immediately after the procedure. No tests are performed after a tubal ligation to determine the surgery has been successful. The failure rate is about 0.2% to 1.0%.

Costs of Vasectomy vs Tubal Ligation for Women

The cost of vasectomy is much less than a tubal ligation. Men can expect charges from $350 to $1,200 for a vasectomy, depending on where they live, the type of vasectomy performed, and where it was done. Most insurance carriers cover vasectomy, but men may be responsible for some out-of-pocket charges.

A conventional tubal ligation costs $10,000 or more because it requires anesthesia and the use of an operating room. Insurance companies often cover some of the expense. Essure and Adiana cost about $4,000 when they are performed in a doctor’s office. An additional x-ray charge should be added to your expected costs: an x-ray is required three months after Essure or Adiana to make sure the blockage of the fallopian tubes is complete.

Complications of Vasectomy vs Tubal Ligation for Women

A look at complications of vasectomy vs tubal ligation for women shows that conventional tubal ligation can cause a greater number and more severe complications than those associated with either Essure or Adiana. That’s because hysteroscopic sterilization procedures do not involve incisions or general anesthesia. A conventional tubal ligation also is associated with more severe and a greater number of complications than a vasectomy. Complications may include nausea and vomiting, minor infection, minor bleeding, bruising, and delayed return of bowel and/or bladder function.

Complications occur in about 1% to 2% of scalpel vasectomies and in 0.1% to 0.2% of no-scalpel vasectomies. The difference is due mostly to the fact that a no-scalpel vasectomy has a smaller skin opening, which virtually eliminates the chance of infection or bleeding. Complications associated with vasectomy may include an allergic reaction to the anesthesia, bleeding, chronic orchialagia, inflammation of the epididymis, immune reactions, infection, post vasectomy pain syndrome, sperm granulomas (lumps of leaked sperm).

About Dr. Larry Lipshultz, M.D.

Dr. Lipshultz is Professor of Urology and Chief of the Division of Male Reproductive Medicine and Surgery at the Baylor College of Medicine in Houston, Texas . He is an internationally acclaimed fertility specialist and a pioneer in the field of urologic microsurgery, specializing in male infertility, erectile dysfunction, microsurgery, genetic causes of infertility, and age-related changes in male hormone levels (androgen replacement). He was a founder of the Society for the Study of Male Reproduction and is a Past President of the American Society for Reproductive Medicine. In addition, he has served on the FDA Advisory Committee for Reproductive Health Drugs. He was the first AUA Research scholar and was awarded the prestigious Hugh Hampton Young Award at the 2005 AUA Annual Meeting. More on Dr. Lipshultz

Site last updated 28 October, 2016



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