All available surgical methods of sterilization prevent the union of sperm and egg, either by preventing the passage of sperm into the ejaculate (vasectomy) or by permanently occluding the fallopian tube (tubal ligation and hystero-scopic sterilization).
Although it is possible to reverse some forms of sterilization, the difficulty of doing so, combined with the generally poor rate of success and the financial expense, demands that patients con-sider the procedure permanent.
The physician should counsel couples who are considering surgical sterilization and assist them in determining the best method.
Changes in operative techniques; anesthesia methods; and attitudes of the public, insurance providers, and physi-cians have contributed to the rapid increase in the number of sterilization procedures performed each year. Modern methods of surgical sterilization are less invasive, less ex-pensive, safer, and as effective—if not more effective—than those used in the past (Table 25.1).
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