Male or female sterilization: a comparative study

Abstract

The study compares 709 males and 546 females recruited from a well-defined geographic area and sterilized during a 5-year period at the same hospital. Medical records were reviewed and questionnaires sent out. Widespread satisfaction with the sterilization was found. The sterilized women had experienced contraceptive side effects and failures more often than the men. Only 70% of the laparoscopic sterilizations could be carried out during a 1-day admission, 25% of the women complained about long-term sequelae, and there were 1% failures. The vasectomies were carried out on an outpatient basis, there were few postoperative symptoms, and 0.5% failures were recorded. Female sterilization was at least four times as expensive as vasectomy. It is concluded that vasectomy is generally to be preferred to female sterilization, and that the preoperative guidance should involve both man and wife.

PIP: 810 men and 594 women, sterilized at a hospital in Denmark between 1978-1982, were sent a questionnaire to determine their motivation, postoperative effects, and satisfaction. The men were vasectomized under local anesthesia on an outpatient basis. The women were sterilized either by laparoscopy, using the Falope Ring technic, or by minilaparotomy, using Pomeroy's method under general anesthesia, and either stayed overnight in hospital or were discharged on the evening of the surgery. The women tended to belong to a lower social class, 15% were unemployed, and 16% were single parents. The men tended as a group to be older. More women gave health reasons, contraceptive failure, fear of the pill's side effects, and marital problems as their reason for wanting sterilization. After sterilization, 21% of the women experienced menstrual changes and/or pelvic pain, and 8 women became pregnant. 2 of the men developed hematomas, and 4 caused pregnancies. 3% of men and 2% of women experienced a deterioration of their sex lives; 40% of men and 36% of women said their sex lives improved; and 57% of men and 62% of women said it was unchanged. 3% of men and 5% of women regretted the decision, and all felt that they had received insufficient information before surgery. The cost of a male sterilization is estimated at $60 and the cost of a female sterilization is estimated at $240. In view of the cost difference and the difference in the invasiveness of the procedure, more men should be motivated to be the sterilized partner.