What is Transcervical Hysteroscopic Sterilization

Transcervical hysteroscopic sterilization is a procedure performed to permanently prevent pregnancy. During the procedure, tiny coils (microinserts) are placed into the fallopian tubes.

After the microinserts are placed, scar tissue will form in the fallopian tubes, which will prevent eggs from reaching the uterus. If an egg cannot reach the uterus, sperm cannot fertilize it.

Transcervical means that the procedure is done through the vagina and lower part of the uterus (cervix). No incisions are needed in this procedure. It takes at least 3 months after the procedure to determine if the fallopian tubes are blocked.

You will need to use another form of birth control for at least 3 months. After that period, you will need to have an X-ray procedure (hysterosalpingography) to confirm that the tubes are blocked.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with the use of anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines or to the microinserts.
• A hole (perforation) in the uterus or the fallopian tubes.
• Damage to other structures or organs.
• Microinserts falling out (extrusion).
• Ongoing (chronic) or short-term (acute) pelvic pain.
• Painful menstrual periods.
• A pregnancy that grows inside a fallopian tube instead of the uterus (ectopic pregnancy).
• One or both fallopian tubes not becoming fully blocked.

What happens before the procedure?

• Ask your health care provider about:
  • Changing or stopping your normal medicines. This is important if you take diabetes medicines or blood thinners.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
• Talk with your health care provider about birth control. If you are not using birth control, you may need to start using it 2–3 weeks before the procedure. This can help make the procedure easier. It also ensures that you are not pregnant.
• You may have a pregnancy test.
• You may need to keep track of your menstrual cycle. This procedure works best when it is done about 7 days after your period starts.

What happens during the procedure?

• You will lie on your back with your feet in foot rests (stirrups).
• A warm metal or plastic instrument (speculum) will be placed in your vagina to allow your health care provider to see your cervix.
• A medicine may be injected into your cervix to numb it (local anesthetic).
• A thin tube that has a light and camera (hysteroscope) will be put into your vagina, through your cervix, and into your uterus. The hysteroscope allows your health care provider to see the openings to both fallopian tubes.
• Through the hysteroscope, microinserts will be put into the fallopian tube openings. They will unwind once they are in place.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• You may have mild cramping, bleeding, or discharge.

Summary

• Transcervical hysteroscopic sterilization is a procedure performed to permanently prevent pregnancy.
• During the procedure, tiny coils (microinserts) are placed into the fallopian tubes. After the microinserts are placed, scar tissue will form in the fallopian tubes, which will prevent eggs from reaching the uterus.
• You will need to use another form of birth control for at least 3 months after your procedure. After that period, you will need to have an X-ray procedure (hysterosalpingography) to confirm that the tubes are blocked.

Transcervical Hysteroscopic Sterilization, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Mild abdominal cramps.
• Mild vaginal bleeding or discharge for a few days.

Follow these instructions at home:

• Slowly return to your normal activities 6–8 hours after the procedure. Ask your health care provider what activities are safe for you.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Use sanitary pads as needed. Do not use tampons for 24 hours after your procedure.
• Use another form of birth control for 3 months, or for as long as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important. Three months after your procedure, you will need to have a procedure (hysterosalpingography) to make sure your fallopian tubes are completely blocked.

Contact a health care provider if:

• You have prolonged, bright red bleeding.
• You have a bad smell or discharge coming from your vagina.
• You have severe pain.
• You have a fever.

Get help right away if:

• You faint.
• You have chest pain.
• You have shortness of breath.

Summary

• After the procedure, it is common to have mild cramps and vaginal bleeding.
• Use another form of birth control for 3 months, or for as long as told by your health care provider.
• Three months after your procedure, you will need to have a procedure (hysterosalpingography) to make sure your fallopian tubes are completely blocked.