Name of the Procedure:

Permanent Implantable Contraceptive Intratubal Occlusion Device(s) and Delivery System
Common names: Permanent birth control, Non-surgical tubal occlusion
Medical terms: Permanent implantable contraceptive, Intratubal occlusion

Summary

A permanent birth control method where a small device is placed into each of a woman's fallopian tubes to block them. This procedure prevents the sperm from reaching the egg, thereby preventing pregnancy.

Purpose

Medical Conditions:

• Desire for permanent contraception.

Goals/Expected Outcomes:

• Provide a long-term, permanent solution for birth control without the need for daily, monthly, or periodic attention.
• To prevent unintended pregnancies.

Indications

Symptoms/Conditions:

• Women seeking permanent contraception.

Patient Criteria:

• Completed childbearing or do not wish to become pregnant in the future.
• Discussed and comprehended the permanence of the procedure with a healthcare provider.

Preparation

Pre-Procedure Instructions:

• Evaluate with a healthcare provider.
• Possibly avoid certain medications (e.g., blood thinners) before the procedure.
• Follow specific instructions provided by the healthcare team.

Diagnostic Tests:

• Pregnancy test to ensure the patient is not currently pregnant.
• Fertility counseling and thorough patient history review.

Procedure Description

1. The patient is usually placed under local anesthesia.
2. A hysteroscope (a thin, lighted tube) is inserted through the cervix and into the uterus to guide the placement.
3. Small devices are placed into the fallopian tubes through the hysteroscope.
4. The devices cause tissue growth that permanently blocks the tubes.
5. The procedure typically does not require incisions.

Tools/Equipment:

• Hysteroscope, implantable occlusion devices.

Anesthesia:

• Local anesthesia, sometimes accompanied by mild sedation.

Duration

Typically about 30 minutes to an hour.

Setting

Outpatient clinic, surgical center, or hospital.

Personnel

• Gynecologist or specialist surgeon
• Nurses
• Anesthesiologist (if sedation is used)

Risks and Complications

Common Risks:

• Pain, cramping, or bleeding immediately after the procedure.
• Incomplete occlusion requiring additional procedures.

Rare Risks:

• Infection.
• Perforation of the fallopian tubes or uterus.
• Allergic reaction to the device or anesthesia.

Management:

• Follow-up care to monitor and address any complications.

Benefits

• Permanent birth control solution.
• No need to remember daily medications or regular contraceptive measures.
• Quick recovery time compared to surgical options like tubal ligation.

Recovery

Post-Procedure Care:

• Rest on the day of the procedure.
• Avoid heavy lifting or strenuous activity for a few days.
• Pain relief with over-the-counter medication as needed.

Expected Recovery Time:

• Most women return to normal activities within a day or two.
• Sexual activity can usually be resumed shortly afterward, as advised by the healthcare provider.

Follow-Up:

• A confirmation test (e.g., HSG - hysterosalpingogram) after a few months to ensure the tubes are fully occluded.

Alternatives

Other Treatment Options:

• Tubal ligation (surgical).
• Long-acting reversible contraception (IUDs, implants).
• Hormonal birth control methods (pills, patches, injectables).

Pros and Cons:

• Alternatives like IUDs and hormonal methods
  • less permanent but require ongoing management.
• Surgical options
  • very effective; involve more significant recovery and surgical risks.

Patient Experience

During Procedure:

• Mild to moderate discomfort due to the anesthesia and the procedure itself; typically well-tolerated.

After Procedure:

• Mild cramping or discomfort.
• Manageable pain levels with over-the-counter pain relievers.
• Minimal downtime and quick return to normal activities.