Indications and Procedures (Magill’s Medical Guide, Sixth Edition)
Sterilization, of either a woman or a man, is a permanent method of surgical contraception that is used to render a couple incapable of conceiving children. Female sterilization involves the blockage or removal of the Fallopian tubes, the ovaries, or the uterus. Male sterilization involves the interruption of the vas deferens, the pathway of sperm from the testicles. The vas deferens may be reconnected, while many of the sterilization procedures performed on women are considered irreversible. Although the most frequently utilized types of female sterilization possess the potential for reversal at a later date, attempted reversals are often unsuccessful. Therefore, a woman choosing this type of contraception should be quite sure that she does not want another child. By the beginning of the twenty-first century, sterilization was the most prevalent form of contraception worldwide, with an estimated one hundred million women choosing the procedure. In the United States, approximately 700,000 women are sterilized each year. One reason that female sterilization is a popular form of contraception with women is because it represents a onetime effort that is usually both simple and the cause of only mild side effects. Another advantage of sterilization over the use of birth control pills is its high success rate: Less than a tenth as many sterilized women will become pregnant (as a result of improperly performed or incomplete...
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Uses and Complications (Magill’s Medical Guide, Sixth Edition)
The most popular method of female sterilization is to block or damage both Fallopian tubes so that eggs cannot pass through them to the uterus. In some cases, the tubes are removed completely. While removal ensures successful sterilization, it is irreversible and considered too drastic by women who might someday wish to reverse the operation. Several popular alternatives to removal are the methods that interrupt the tubes, retaining the potential for reversal at a later date. Women undergoing this type of surgery are warned, however, that such reversal may be impossible.
When the Fallopian tubes are damaged but not entirely closed off, they may reconnect and cause an ectopic pregnancy, in which a fertilized egg implants in one of the tubes and begins to grow into a fetus. Ectopic pregnancy can be fatal to the pregnant woman, and when identified, it is corrected by surgical removal of the fetus. Although the cause of this problem is not clear, there is some thought that alteration of the interior wall of the tube or slowed passage of an egg through the tube may be the causative agent. Fortunately, ectopic pregnancy is relatively uncommon.
Whether the laparoscopic method or the direct approach is utilized, the best time to carry out female sterilization is at the end of a menstrual cycle; at this time, early pregnancies cannot be compromised. It is advised that the patient discontinue intercourse and the use of...
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Perspective and Prospects (Magill’s Medical Guide, Sixth Edition)
While surgical sterilization was first described in the nineteenth century, it was not widely available for contraception until the 1920’s, nor did it become popular immediately. Though voluntary sterilization began slowly in the 1950’s, its use accelerated until it became a popular form of fertility control in the industrial and developing nations of the 1970’s.
A source of discontent with the sterilization techniques that are available is their total or poor reversibility when fertility reinitiation is desired later in life. This discontent has occurred because, with passing time, an unexpectedly large segment of sterilized men and women have come to regret their decisions regarding sterilization. All hysterectomies and Fallopian tube removals are forever irreversible, and a low reversibility rate is seen even in the two most popular—and potentially reversible—sterilization methodologies: Fallopian tube interruption and vasectomy.
Consequently, the development of sterilization surgery has been directed toward devising methods that will enable much larger incidences of reversibility, where desired. One direction has been to expand the understanding of Fallopian tube and vas deferens anatomy and functionality. Particularly useful results obtained include the realization that destruction of the nerves that control the operation of these organs can make the recovery of fertility incomplete or...
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For Further Information: (Magill’s Medical Guide, Sixth Edition)
Ammer, Christine. The New A to Z of Women’s Health: A Concise Encyclopedia. 6th ed. New York: Checkmark Books, 2009. A respected classic that covers the full spectrum of women’s health issues, including reproduction and methods of contraception.
Connell, Elizabeth B. The Contraception Sourcebook. Chicago: Contemporary Books, 2002. A straightforward guide that provides comprehensive coverage of each contraceptive method, including a clear and understandable analysis of its advantages and disadvantages as well as a lively discussion of its origins.
Denniston, George C. Vasectomy. Victoria, B.C.: Trafford, 2002. Provides a range of information for men who are considering a vasectomy.
Mastroianni, Luigi, Jr., Peter J. Donaldson, and Thomas T. Kane. Developing New Contraceptives: Obstacles and Opportunities. Washington, D.C.: National Academy Press, 1990. This book on contraceptive measures other than sterilization by surgery also contains considerable useful information on sterilization practices and legalities. Provides useful insights and allows the reader to consider other effective, long-term methods of contraception, excluding surgery.
Parker, James N., and Philip M. Parker, eds. The Official Patient’s Sourcebook on Vasectomy. San Diego, Calif.: Icon Health, 2002. Draws from public, academic, government, and peer-reviewed research to provide a...
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Sterilization (West's Encyclopedia of American Law)
A medical procedure where the reproductive organs are removed or rendered ineffective.
Legally mandated sterilization of criminals, or other members of society deemed "socially undesirable," has for some time been considered a stain on the history of U.S. law. The practice, also known as eugenics, originated early in the twentieth century. In 1914, a Model Eugenical Sterilization Law was published by Harry Laughlin at the Eugenics Records Office. Laughlin proposed the sterilization of "socially inadequate" persons, which translated as anyone "maintained wholly or in part by public expense." This would include the "feebleminded, insane, blind, deaf, orphans, and the homeless." At the time the model law was published, 12 states had enacted sterilization laws. Such laws were seen to benefit society since they presumably reduced the burden on taxpayers of maintaining state-run facilities. Eventually, these laws were challenged in court.
In BUCK V. BELL, 274 U.S. 200 (1927), OLIVER WENDELL HOLMES JR. wrote the infamous opinion that upheld the constitutionality of a Virginia sterilization law, fueling subsequent legislative efforts to enact additional sterilization laws. By 1930, 30 states and Puerto Rico had passed laws mandating sterilization for many criminal or moral offenses. Nearly all of the states with such laws imposed mandatory sterilization of mentally defective...
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Sterilization (World of Microbiology and Immunology)
Sterilization is a term that refers to the complete killing or elimination of living organisms in the sample being treated. Sterilization is absolute. After the treatment the sample is either devoid of life, or the possibility of life (as from the subsequent germination and growth of bacterial spores), or it is not.
There are four widely used means of sterilization. Standard sterilization processes utilize heat, radiation, chemicals, or the direct removal of the microorganisms.
The most widely practiced method of sterilization is the use of heat. There are a number of different means by which heat can be applied to a sample. The choice of which method of delivery depends on a number of factors including the type of sample. As an example, when bacterial spores are present the heating conditions must be sufficient to kill even these dormant forms of the bacteria.
A common type of heat sterilization that is used many types each day in a microbiology laboratory is known as incineration. Microorganisms are burned by exposing them to an open flame of propane. "Flaming" of inoculating needles and the tops of laboratory glassware before and after sampling are examples of incineration.
Another form of heat sterilization is boiling. Drinking water can be sterilized with respect to potentially harmful microorganisms such as Escherichia coli by heating the water to a temperature of 212°F (100°C) for five minutes. However, the dormant cyst form of the protozoan Giardia lamblia that can be present in drinking water, can survive this period of boiling. To ensure complete sterility, the 212°F (100°C) temperature must be maintained for 30 minutes. Even then, some bacterial spores, such as those of Bacillus or Clostridium can survive. To guarantee sterilization, fluids must be boiled for an extended time or intermittent boiling can be done, wherein at least threend up to 30eriods of boiling are interspersed with time to allow the fluid to cool.
Steam heat (moist heat) sterilization is performed on a daily basis in the microbiology laboratory. The pressure cooker called an autoclave is the typical means of steam heat sterilization. Autoclaving for 15 minutes at 15 pounds of pressure produces a temperature of 250°F (121°C), sufficient to kill bacterial spores. Indeed, part of a quality control regiment for a laboratory should include a regular inclusion of commercially available bacterial spores with the load being sterilized. The spores can then be added to a liquid growth medium and growth should not occur.
Pasteurization is employed to sterilize fluids such as milk without compromising the nutritional or flavor qualities of the fluid.
The final form of heat sterilization is known as dry heat sterilization. Essentially this involves the use of an oven to heat dry objects and materials to a temperature of 32038°F (16070°C) for two hours. Glassware is often sterilized in this way.
Some samples cannot be sterilized by the use of heat. Devices that contain rubber gaskets and plastic surfaces are often troublesome. Heat sterilization can deform these materials or make them brittle. Fortunately, other means of sterilization exist.
Chemicals or gas can sterilize objects. Ethylene oxide gas is toxic to many microorganisms. Its use requires a special gas chamber, because the vapors are also noxious to humans. Chemicals that can be used to kill microorganisms include formaldehyde and glutaraldehyde. Ethanol is an effective sterilant of laboratory work surfaces. However, the exposure of the surface to ethanol must be long enough to kill the adherent microorganisms, otherwise survivors may develop resistance to the sterilant.
Another means of sterilization utilizes radiation. Irradiation of foods is becoming a more acceptable means of sterilizing the surface of foods (e.g., poultry). Ultraviolet radiation acts by breaking up the genetic material of microorganisms. The damage is usually too severe to be repaired. The sole known exception is the radiation-resistant bacteria of the genus Deinococcus.
The final method of sterilization involves the physical removal of microorganisms from a fluid. This is done by the use of filters that have extremely small holes in them. Fluid is pumped through the filter, and all but water molecules are excluded from passage. Filtersow in routine use in the treatment of drinking wateran be designed to filter out very small microorganisms, including many viruses.
See also Bacterial growth and division; Bacteriocidal, bacteriostatic; Laboratory techniques in microbiology