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Surgical sterilization


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family planning method

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Surgical sterilization

  1. 1. PRESENTATION on Voluntary Surgical sterilization 1
  2. 2. Estimated Time: 25 min Presentation slide: 31 Group Member Manisha Basnet Babita kattuwal Kaberi jha Rabin Dani Bikas Pudasaine Sudip Thapa Sasi kiran Devkota Bhojan Dhakal 2
  3. 3. ∗ Introduction ∗ Objectives ∗ Mode of action ∗ Advantage / Disadvantage ∗ Side effects ∗ Indication / Contraindication ∗ Availability Presentation plan 3
  4. 4. ∗Voluntary Surgical sterilization is the permanent method of family planning for men and women who are sure that they will not want more children .  For men - Non Scalpel Vasectomy (NSV)  For women - Minilap - Laparoscopy Voluntary Surgical sterilization 4
  5. 5. VASECTOMY Introduction vasectomy is a surgical procedure performed on males in which the vasa differentia (tubes that carry sperm from the testicles to the seminal vesicles) are cut, tied, cauterized (burned or seared), or otherwise interrupted. The procedure is done under local anesthesia and takes only 15- 20 minutes. There is no need of any overnight stay.  Now a days non scalpel or key hole vasectomy is done which don’t required stitch. Fully effective only after 20 ejaculations or 3 months. The man should use condoms or his partner should use another method until then. Vasectomy is 99.99% effective as birth control Vasectomy 5
  6. 6. Background NSV originally developed in China in 1974 and first introduced in the United States in 1984,  In Nepal it was started in 1992 and the training as such started in 1996. Vasectomies are 99.99% successful in preventing conception. The semen no longer contains sperm after the tubes are cut, so conception cannot occur. The testicles continue to produce sperm, but they die and are absorbed by the body. Non scalpel vasectomyVasectomy 6
  7. 7. ∗ To avoid unwanted birth. ∗ To make family life healthy Objectives 7
  8. 8. Stripping of fascia to expose loop of vasANESTHESIA 8
  9. 9. Cut and closed tubes 9
  10. 10. The health care provider makes a small opening in the man's scrotum (the sac of skin that holds his testicles) and closes off both tubes that carry sperm from his testicles. This keeps sperm out of his semen. The man still can have erections and ejaculate semen. His semen no longer makes a woman pregnant, however, because it has no sperm in it. How does it work ? (MoA) 10
  11. 11. ∗ Permanent, A single quick procedure leads to lifelong, safe and very effective family planning. ∗ No fear about pregnancies. ∗ Vasectomy is a safer, procedure that causes fewer complication than tubal ligation in female. ∗ No need to worry about using other birth control methods ∗ Vasectomy is cheaper and fewer complications than tubule sterilization. Advantages 11
  12. 12. ∗ It does not protect against sexually transmitted infections., including HIV. ∗ Not immediately effective. The first 20-30 ejaculations after vasectomy may contain sperm. The couple must use another contraceptive method for the first 20-30 ejaculations or the first 3 months. ∗ Common minor short-term complications of NSV : - Usually uncomfortable for 2 or 3 days, - Pain in the scrotum, swelling and bruising (emotionally feel injured) ∗ The man who wants to open a vasectomy can be done in a way that is reconnect the channel sperm, but the small chances of success Disadvantages 12
  13. 13. Rarely: ∗Bleeding under the skin, which may cause swelling. ∗Infection at the side of the incision. ∗Pain, fever. Side Effect 13
  14. 14. ∗ The client who seeks permanent method and wants no more children. ∗ The client should be above the age of 22 years and below the age of 49 years. However, with adequate counseling there is no age restriction. ∗ There should be at least 2 living children. However, with adequate counseling there is no parity restriction. Indication of NSV 14
  15. 15. ∗ Any problems with genitals such as infection, swelling, injuries, lumps in penis or scrotum. ∗ Some other serious conditions or infections. Contraindication 15
  16. 16. Common Myth in NSV NSV can loose sexual desire: vasectomy will not affect a man’s sex life or production of male hormones. Following a vasectomy a man will continue to enjoy sex and produce the same amount of semen when he ejaculates but the semen will not contain sperm that can impregnate a woman. 16
  17. 17. Female Sterilization 17
  18. 18. Introduction  Minilap tubectomy, generally referred to as “Minilap” is a surgical approach to the fallopian tubes by means of an incision 2-5 cm in length., It has been performed safely and frequently in a wide.  It is a safe and simple surgical procedure. It can usually be done with just local anesthesia. Proper infection-prevention procedures are required.  Female sterilization is a form of contraception that involves cutting or sealing the Fallopian tubes.  Minilap is the most common used method of family planning.  Female sterilization are 99.5% effective as birth control. Minilap 18
  19. 19. ∗ Female sterilization was firstly used in the 19th century by James Blundell. Background 19
  20. 20. ∗ To provides permanent contraception for women who will not want more children. ∗ Improve overall reproductive health of individual and couples. ∗ Reduce Total Fertility Rate Objectives 20
  21. 21. Female Sterilization 21
  22. 22.  Sterilization usually involves 1 small incision just below the navel Fig : Minilaparotomy for female.  Minilaparotomy for female sterilization involves a small incision just above the pubic hair. Fig : Laparoscopy for female 22
  23. 23. ∗ The health care provider makes a small incision in the woman's abdomen and blocks off or cuts the 2 fallopian tubes. These tubes would carry eggs from the ovaries to the uterus. With the tubes blocked, the woman's egg cannot meet the man's sperm. The woman continues to have menstrual periods. Minilap How does it work? (MoA) 23
  24. 24. ∗ Very effective. ∗ Helps protect against: - Risks of pregnancy - Pelvic inflammatory disease (PID) ∗ May help protect against: - Ovarian cancer ∗ No interference with sex. Does not affect a woman's ability to have sex. ∗ Increased sexual enjoyment because no need to worry about pregnancy. Advantages 24
  25. 25. ∗ No protection against sexually transmitted infections (STI) including HIV. ∗ Usually painful at first, but pain starts to go away after a day of surgery. ∗ Uncommon complications of surgery: - Infection or bleeding at the incision, - Internal infection or bleeding, ∗ Pregnancies among users of voluntary sterilization are few. But when pregnancy occurs, it is more likely to be ectopic than the average pregnancy. Disadvantages 25
  26. 26. Rarely: ∗Infection at the side of the incision. ∗Bleeding under the skin, which may cause swelling. Side effects 26
  27. 27. Interval Minilap may be performed: During menstruation, or within 5 days of LMP or any time in the menstrual cycle if client is known to be not pregnant. The client seeks permanent method and wants no more children. The client should be above the age of 22 years and below the age of 49 years. However, with adequate counseling there is no age restriction. There should be at least 2 living children. However, with adequate counseling there is no parity restriction. Do not need to have husbands/guardians permission. Indication 27
  28. 28. Women who wants give birth to other baby. Some other serious conditions or infections. Contraindication 28
  29. 29.  Does not make women weak. ∗ Does not cause lasting pain in back, uterus, or abdomen. ∗ Does not remove a woman’s uterus. ∗ Does not cause hormonal imbalances. ∗ Does not cause heavier bleeding or irregular bleeding or otherwise change women’s menstrual cycles. ∗ Not cause any changes in weight, appetite, or appearance. ∗ Does not change women’s sexual behavior or sex drive / desire. Correcting Misunderstandings 29
  30. 30. ∗ At least one type of VSC service was made available in all districts except Ilam and Manang through hospitals , family planning association Nepal and mobile outreach services. VSC mobile outreach program was conducted in 73 districts in FY 2069/70. Availability of surgical sterilization
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