Failure of Sterilization

When a man or woman no longer wishes to procreate and they are certain the decision is permanent, they may wish to have a permanent form of sterilization. In men, this is a vasectomy and in women, the procedure is called a tubal ligation. The tubal ligation is more complex than a vasectomy and usually requires general anesthesia. On the other hand, the vasectomy can be done under local anesthesia and takes less time to perform than a tubal ligation.

The tubal ligation involves using laparoscopy or an open pelvic procedure. The fallopian tubes are isolated from the rest of the pelvic tissue and clamps are placed to keep the tube isolated. The tube is then cut, with a section cut out to be evaluated under pathology. The cut ends are sometimes burned or cauterized and they are tied off. The second tube is then done in an identical fashion. A tubal ligation is successful on a permanent basis in excess of 99 percent of the time.

Unfortunately, tubal ligations sometimes fail. They fail because the surgeon mistakes a portion of the uterine membrane as a piece of the tube and doesn't cut out the tube at all. This is a rare occurrence and is made easier if the piece of tube is looked at under the microscope to make sure that fallopian tube has in fact been cut. In even rarer circumstances, the tube can connect itself back up again. This can happen over a many month period of time and is made a lesser complication if a section of tube is cut out rather than just bisecting the tube. If the tube reconnects, a pregnancy can come up as a secondary complication.

If you sustain a pregnancy after tubal ligation, you need to have your attorney or yourself examine the medical record. Make sure that a section of tube was evaluated under the microscope. This should be the gold standard of tubal ligations and, if done correctly, can tell the difference between a tube that has simply reconnected and one that never was disconnected in the first place.

The vasectomy has a higher success rate than the tubal ligation and the failure of sterilization is in the range of one out of every thousand. The vasectomy is done using local anesthesia which numbs an area of skin in the groin area. The vas deferens is isolated out from the blood vessels and nerve in the same bundle in the groin, leading between the pelvic structures and the testicle. When the vas deferens is isolated out, it is bisected and a section of the tube is isolated out and removed for pathological examination. This makes sure that vas deferens is removed and not some connective tissue, blood vessel or nerve. The vas deferens is tied off at each end and is sometimes cauterized. The bundle of tissue is then replaced into the groin and sutures are placed to close the incision, which is less than an inch long. The process is repeated at the other side of the groin so that both vas deferentia are bisected.

As mentioned, failure of vasectomy is rare, especially when a section of the vas deferens is looked at under the microscope to make sure the right tissue was taken. Technically, the vas deferens can reconnect on its own but it does so at a lesser rate than the fallopian tubes. In most cases of vasectomy, the patient is asked to give samples of semen for up to six months after the procedure. When the semen shows no motile sperm, the vasectomy is considered a success and a man can be certain he can't get a woman pregnant again.