Vasectomy vs. Tubal Ligation/Essure

Tubal Ligation and Essure® versus a Vasectomy

Female sterilization versus male sterilization pros and cons

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One of the most important decisions you will make in your life is one to undergo a permanent contraception or sterilization procedure.  Often this decision not to have any more children is viewed as a woman’s issue.  When a couple has decided that their family is complete or they do not wish to have an unplanned pregnancy, an informed decision on the facts about a woman undergoing a surgical procedure (tubal ligation) should  be evaluated against a man undergoing a minimally invasive vasectomy procedure.

The main features of the two procedures are summarized as follows:

  • Tubal Ligation
  • Hospital OR procedure
  • General anesthesia usually 30 minutes to 1 hour (dependent on type)
  • Significant recovery required
  • Significant pain and discomfort
  • 4 times more expensive than a vasectomy
  • Rarely reversible
  • No Needle/No Scalpel Vasectomy
  • In-office procedure
  • No-Needle local anesthesia
  • 15 minutes or less
  • Most normal activities resumed in 24-48 hours
  • Minimal discomfort
  • ¼ the cost of tubal ligation
  • Reversal usually possible

What is the infection rate for a tubal ligation as compared to a vasectomy?

An equally important decision factor is the potential for infection.  For a hospital operating room (OR) procedure, infection rates are typically in the 3% range.  For an in-office No-Needle No-Scalpel vasectomy, the infection rate is less than 0.5%.

What is the failure rate of tubal ligation and vasectomy?

The failure rate for a tubal ligation is 0.2% to 0.4%, a little higher than a  vasectomy.  It should be noted that with a vasectomy it’s easy to check a man’s ejaculate to determine the absence of sperm.  After a tubal ligation, there’s no simple test that is done to ensure that it was successful .  An invasive procedure with injection of dye into the uterus is necessary to assure occlusion of the tubes.

Is there a non-surgical method for female sterilization?

Yes, there is a procedure called Essure® which is approved by the FDA as a sterilization procedure for women. The Essure® system requires the insertion of two coils to be placed in a woman’s fallopian tubes.  Because the coils are  inserted through the vagina, there is no surgical incision.  Over a period of three months, the Ensure® procedure works by creating scar tissue, thereby blocking the fallopian tubes from transporting sperm to the egg. To determine if the procedure was successful, as with the tubal ligation, an uncomfortable  radiographic procedure (hysterosalpingography) is used to confirm that the fallopian tubes are blocked.

There have been numerous complaints to the FDA about complications from the Essure® procedure. For more information on FDA Essure®  complaints visit:

When should a couple choose a tubal ligation instead of a vasectomy?

If the wife is delivering by C-Section and they have chosen permanent sterility, it is frequently preferable to perform a tubal ligation at the same sitting.

Almost every other time, we believe that a couple is best served by a vasectomy instead of a tubal ligation.  Why?  That’s an easy question – here’s why a No-Needle No-Scalpel Vasectomy is the preferred choice for most couples.  A vasectomy:

  • is safer
  • is less painful
  • does not require general anesthesia
  • does not need to be done in a hospital or surgery center
  • is a faster procedure
  • has a lower infection risk
  • is far less expensive
  • can usually be reversed
  • has an extremely high patient satisfaction rate

For most couples, after they carefully consider the two procedures, a vasectomy is the clearer, safer and easier choice when making a decision for a permanent form of birth control.

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