HealthONE May 09, 2016

Is your family complete and you are considering a permanent form of contraception? Depending on each patient’s preferences and individual case, one of two options for permanent sterilization is available: the Essure® Tubal Occlusion or laparoscopic tubal ligation surgery. 

As I tell my patients Women’s Care of Colorado, both forms are viable means to achieving the same result. 

Essure® Tubal Occlusion 

Over the last 10 years, Essure Tubal Occlusion has grown in popularity thanks to its ease of performance through minimally invasive surgery outside the operating room. Women who choose Essure as an option for permanent sterilization are not anesthetized, only require a few medications for pain management during the procedure and are out of the office in about an hour.

With the assistance of a hysterscope, small coils are inserted into the fallopian tubes through the vagina. Once inserted, the body develops scar tissue over the coils, effectively blocking sperm from reaching the egg.

After three months, the patient will have an HSG, an x-ray dye test to determine if the scarring has completely blocked the fallopian tubes. Because the scarring takes time, addition birth control is still needed during these three months.

Many women prefer the Essure procedure over a laparoscopic tubal ligation because it can be performed in the office without general anesthesia and with no abdominal incisions. Some women complain of cramping (the medicine is designed to alleviate this), but are able to resume normal activity the following day.

After the procedure, placing anything in the vagina and sexual intercourse are strongly advised against for two weeks. 

Laparoscopic Tubal Ligation/ Removal

Performed by an OB/GYN physician in the operating room, a laparoscopic tubal ligation is an out patient surgery administered under general anesthesia. The surgery itself takes less than an hour, with two to three small incisions (about 1cm) made on the abdomen.

During the procedure, the physician will either completely remove the fallopian tubes or use what is called a Filshie® Clip to obstruct the tubes, preventing eggs from traveling from the ovaries to the uterus.

As is the case with any surgical intervention, a laparoscopic tubal ligation carries with it increased risk of complications and a more painful recovery time than the Essure procedure. After surgery, we advise limited activity for one-two week and no sexual intercourse for at least two weeks.

Even though surgery is slightly more risky than the Essure procedure, the fallopian tubes are completely blocked upon completion, and additional birth control is unnecessary as it is after the Essure Tubal Occlusion.

Choosing the Right Option

Both procedures have their own benefits, and choosing the right option for you and your family is your decision alone. As partners in your OB/GYN care, we are here to help you navigate through your options and decide on the right fit for your family.

Permanent sterilization is a complex subject not only for mothers, but the entire family. I always advise thoughtful consideration when families come to my practice to start the conversation about sterilization as a permanent birth control solution.

While many sterilization options can be reversed, these two are permanent, and should not be pursued if you have any doubt about whether or not you will want another little one joining the family. No matter your decision, we are dedicated to helping you make the right choices for your family’s future.

Dr. Juliet Leman is a Colorado native who returned to the Mile High City after completing her residency in obstetrics and gynecology in Michigan. An OB/GYN physician at Women’s Care of Colorado, her areas of interest include obstetrics, gynecologic surgery and caring for women in all stages of life. Dr. Leman enjoys spending time outdoors with her family and friends and “tries” to enjoy running.