Vasectomy Compared to Tubal Ligation

When a couple considers permanent sterilization, the risks and benefits of tubal ligation (for the female partner) verses vasectomy (for the male partner) are important issues.

In skilled hands, vasectomy has a failure rate approximately equal to tubal ligation, somewhere between 1/200 and 1/500. The success of a vasectomy can be confirmed by doing semen checks.

The success of a tubal ligation cannot be confirmed by any conventional testing (except an unwanted pregnancy). After a vasectomy has been confirmed successful, there remains a small risk of failure over the next 10 years – judged to be approximately 1 in 3000. The risk of failure for tubal ligation increases with the amount of time. While the woman remains fertile, the risk increases by approximately two-fold.

If a vasectomy fails the couple may have to deal with the pregnancy. If tubal ligation fails the most common site of a pregnancy is what is termed an “ectopic pregnancy”. This is a pregnancy in a place other than in the uterus where it supposed to occur. Surgery is often required to extract the non-viable embryo, usually at great risk to the mother.

Vasectomy is a simple straightforward operation. It can be done in a doctor’s office using local anesthesia. Tubal ligation must be done in a hospital using general anesthesia, which carries higher risks. Therefore, surgical risks in vasectomy are considered to be much less than with tubal ligation. In fact, death resulting from a vasectomy is virtually unheard of.

Complications can occur from vasectomy like scrotal hematoma (i.e. a large blood filled scrotum) that takes months to resolve or chronic pain syndrome, which may take months or years to resolve. Serious complications from tubal ligation that can be life threatening occur with a higher frequency. For example bowel or major vessel rupture occurs approximately 1 in 1000 times with tubal ligation. Though very uncommon, complications following tubal ligation can also lead to death.

In summary, as couples become more educated regarding the benefits and risks of these two procedures and men become more sensitive and to the responsibilities incumbent upon them in dealing with birth control, it is likely that the vasectomy will continue to increase in popularity over tubal ligation.

References:

Hendrix NW. Chauhan SP. Morrison JC "Sterilization and its Consequences" Obstetrical and Gynecological Survey. 54 (12): 766-77, 1999 Dec.

Wilson EW "Sterilization" Baillieres Clinical Obstetrics and Gynaecology. 10 (1): 103-19, 1996 Apr.