Dr. Suzanne Welsch: So hysteroscopic sterilization procedures are really a relatively new advent to our specialty. The type of tubal ligation or tubal sterilization procedures that used to be available to women were available really solely through an outpatient surgical procedure which involved general anesthesia or women going fully to sleep. Hysteroscopic sterilization has allowed sterilization to occur in an office setting with women fully awake, though slightly sedated. It is a permanent, non-reversible form of contraception that's 99 plus percent effective against pregnancy. So it's really brought a procedure which, as its biggest risk has been the general anesthetic and eliminated that from the risk profile so it's a very safe option for women, much like vasectomy is for men in that they don't have to take an entire day off of work, there's a very minimal recovery time frame, and the anesthetic piece of it is much less.
So, typically women come in, they're placed on a special procedure table and in what we call lithotomy position, or in stirrups, and a speculum is placed into the vagina. Their cervix is dilated with some special dilators, that are just some metal instruments that we have, and then a camera is placed in through the cervix into the cavity of the uterus, and within the uterus are the two openings to the fallopian tubes. Once we visualize those fallopian tubes, we pass some micro coils into the tubes. These coils will eventually, over the course of the next three months, scar the fallopian tubes, and render them closed. Once we're assured that they're closed, in three months through a specialized test in radiology called an HSG, we can guarantee that the procedure is done and it's final, and women don't need to have backup birth control after that point. Dr. Schad and myself developed this as one of the first clinics to be actually doing this in the office. Many doctors continue to do this procedure but it's done in an operating room. This is an incision-less procedure, so there are no stitches, there are no incisions made, so the recovery from a pain standpoint is significantly better as well.
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