Is it better to tie or not tie?

Sterilization is a method of contraception, and it is more effective. It is now common to choose to undergo sterilization surgery. However, many people are worried that sterilization surgery is harmful to the human body and that it has side effects that may adversely affect the body. Not everyone can undergo sterilization surgery, so is it better to have sterilization or not? Is it better to get a vasectomy or not? Let’s take a look at it next.

1. Is it better to get a vasectomy or not?

There are both advantages and disadvantages to ligation. Tubal ligation only cuts off the channel for the egg and sperm to meet. It is a minor operation and may cause slight pain, wound infection and other problems, but it will not damage or affect the body's physiological functions, nor will it affect health and sex life, and it will not hurt the "vitality".

As long as the wound heals after the operation, the couple can resume their sexual life, and this operation has absolutely no impact on the couple's sexual life. On the contrary, since couples no longer have to worry about pregnancy, their sex life can be more harmonious and fulfilling.

Because it is the ovaries and uterus that affect menstruation and menopause, and sterilization surgery only cuts the fallopian tubes, leaving the uterus and ovaries intact. Therefore, you will still ovulate and menstruate every month, and your menstruation will not stop or be affected in your menstrual flow. There will be no early menopause.

2. Steps

1. It is best to choose a longitudinal incision, but a transverse incision can also be selected. The length is about 2 to 3 cm. For those who have undergone postpartum ligation, the height of the uterine fundus should be determined. If the uterus is too soft after delivery, gently massage it to harden it. The upper edge of the incision should be two horizontal fingers below the uterine fundus. For those who undergo ligation after menstruation, the lower edge of the incision is two horizontal fingers away from the pubic symphysis (upper edge), that is, 3 to 4 cm.

2. Cut the skin and subcutaneous fat layer by layer, cut the anterior sheath of the rectus abdominis muscle, and bluntly separate the rectus abdominis muscle. Extract the peritoneum, avoid the bladder and blood vessels, and avoid clamping the subperitoneal bowel. The peritoneum was confirmed and cut open to enter the abdominal cavity.

3. When searching for the fallopian tube, you must be steady, accurate and gentle. You can use the following methods to extract the fallopian tube.

(1) Fingerboard method: If the uterus is in the posterior position, first return it to the anterior position. Use your index finger to enter the abdominal cavity and touch the uterus, slide along the uterine horn to the back of the fallopian tube, then insert the pressure plate, place the fallopian tube between the finger and the pressure plate, slide them together to the ampulla of the fallopian tube, and then gently take them out together.

(2) Hook method: Place the hook along the anterior abdominal wall through the bladder-uterine pouch, with the back of the hook close to the anterior uterine wall, slide to the back of the uterine fundus, and then slide to one side of the fallopian tube. After hooking the fallopian tube ampulla, gently lift it up. Under direct vision, use toothless forceps to clamp the fallopian tube and gently lift it out. If the hook feels too tight when lifted, it may hook the ovarian ligament. If it is too loose, it may hook the intestinal flexure.

(3) Oval forceps method: If the uterus is in retroverted position, first return it to the anterior position. After inserting the toothless and buckled oval forceps into the abdominal cavity, slide it along the anterior abdominal wall through the bladder-uterine pouch, over the anterior wall of the uterine body to the uterine horn, then separate the two leaves of the oval forceps, slide it toward the fallopian tube, rotate it inward 900, loosely clamp the ampulla of the fallopian tube, and lift out the fallopian tube.

4. All proposed fallopian tubes must be traced back to the fimbria to confirm that the fallopian tubes are correct. Routine examination of both ovaries.

5. The method of blocking the fallopian tube can be based on local experience, but the method must be effective, simple, and have fewer complications.

(1) Proximal core embedding method: Use two tissue forceps to lift the isthmus of the fallopian tube, with the distance between the two forceps about 2 to 3.0 cm. Select the avascular area of ​​the isthmus, first inject a small amount of normal saline under the serosa to make the serosa float, then cut the serosa open, and after freeing the fallopian tube, clamp the two ends with two mosquito forceps, cut off 1-1.5 cm in the middle, ligate the two ends with No. 4 silk thread, and ligate the serosa layer around the distal end at the same time, and use No. 0 silk thread to bury the proximal end and suture it in the serosa of the fallopian tube.

(2) Silver clamp method: Place the silver clamp on the placement forceps, aim the jaws at the raised isthmus of the fallopian tube, and allow the entire transverse diameter of the isthmus to be embraced by the two arms of the silver clamp. Slowly press the clamp handles, compress the upper and lower arms of the clamp, and press the silver clamp tightly against the fallopian tube. Continue to compress for 1 to 2 seconds, then release the upper clamp and check whether the silver clamp is clamped flat on the fallopian tube.

(3) Tubal folding, ligation and cutting (modified Proskauer method): This method is only used when the above methods cannot be implemented.

1) Use a pair of rat-tooth forceps to lift the isthmus of the fallopian tube and fold it.

2) Use a vascular clamp to compress the fallopian tube 1.5 cm from the top for 1 minute.

3) Use No. 7 silk thread to pass through the mesentery, first ligate the proximal fallopian tube at the compression site, then wrap around and ligate the distal side, and if necessary, wrap around and ligate the proximal side again.

4) Cut off a section of the fallopian tube about 1 cm long above the ligature.

The contralateral fallopian tube was ligated in the same way.

6. Check the abdominal cavity and various layers of the abdominal wall for bleeding, hematoma, and tissue damage.

7. Check the gauze and instruments, close the abdominal cavity correctly, and suture the abdominal wall layer by layer with silk thread.

8. Cover the wound with sterile gauze.

3. Reminder

There is no need to worry about whether vasectomy will affect your mood or weight. This is because the surgery does not affect the function of the ovaries, which can secrete female hormones normally, and therefore will not affect your mood or weight. But there may be a very small number of people whose mood is affected by excessive tension. As long as you stay relaxed and optimistic, this situation generally won't happen.