WOMEN wanting to be sterilised will be offered a 30-minute "female snip" as a result of pioneering work by Scottish doctors.
The new procedure avoids the need for abdominal surgery under general anaesthetic and long recovery times. Doctors predict more women will now opt for sterilisation and fewer men will undergo vasectomies.
Current surgery for sterilisation involves
clipping the fallopian tubes through small incisions made via the abdomen under general anaesthetic.
The procedure usually leaves patients with two small abdominal wounds and a recovery time of up to a week. The procedure, which carries a risk of failure or complications, is not suitable for many women.
The new technique has been developed at Edinburgh Royal Infirmary. Doctors insert tiny coils in the fallopian tubes through the cervix, which means women do not need to undergo surgery.
A camera, called a hysteroscope, is then used to see into the womb and locate the openings of the fallopian tubes. Measuring 4cm long and less than a millimetre wide, the coils block the tubes, thus preventing eggs from entering the womb.
Dr Sue Milne, Associate Specialist in Reproductive Medicine at the ERI, has piloted the technique on 20 patients in recent weeks.
"The traditional sterilisation is a big operation and it involves a general anaesthetic and hospital admission. The tubes are clipped and that is the accepted method in most countries."
But she said the failure rate is high, and there is a one in 200 chance of pregnancy. There is also a three in 1,000 chance of damage being done to the bowel or blood vessel.
"That is why we are so excited about this new technique, which has a much lower failure rate," she said.
Milne added that the procedure, called Essure hysteroscopic sterilisation, can be performed in the outpatient clinic.
"The patient just takes over-the-counter painkillers an hour before the procedure. The vast majority of patients don't need any anaesthetic. Afterwards they are fine to go home."
The woman is not immediately sterilised but the blockage in the fallopian tubes takes place over the next three months as the tissues in her fallopian tubes grow into the coil, so she must use another form of contraception in the meantime.
Milne believes the ease of the technique will make it popular among women. Among couples looking for permanent contraception, vasectomy is usually the first line of treatment because it is a more straightforward procedure with fewer serious side-effects, but Milne believes Essure may change things for the future.
She said: "Essure widens the number of women who could have sterilisation. Up until now we have encouraged men to go for the snip because of the risks of sterilisation to women.
"Vasectomy has until now been the less invasive form of sterilisation but Essure is challenging that so it is almost similar to the vasectomy."
Sterilisation is usually performed on women in their 30s and 40s who want a permanent method of contraception.
An estimated 1,500 women undergo sterilisation each year in Scotland compared with around 3,300 men undergoing vasectomies.
Essure is also slightly cheaper at £700 per patient. The traditional procedure costs around £950.
Audrey Burnside, clinical nurse manager for NHS Lothian's gynaecological services, described the procedure as a "landmark achievement in female sterilisation".
She added: "It allows women to undergo sterilisation with minimum pain and disruption to their lives. We are delighted to become the first centre in Scotland to offer the procedure, and we hope to be able to offer it on a more permanent basis within the next year."
A spokeswoman for the Family Planning Association yesterday said: "We really welcome this and we would like to see it made available across the NHS in Scotland. This hospital is really leading the way."
The full article contains 638 words and appears in Scotland On Sunday newspaper.
