This presentation provides information about voluntary surgical sterilization procedures for men and women. It discusses non-scalpel vasectomy and minilaparotomy tubectomy procedures, including how they work, advantages, disadvantages, indications, contraindications, and availability in Nepal. The presentation is estimated to take 25 minutes and contains 31 slides covering topics such as introduction, objectives, mode of action, side effects, and a question and answer section to address common myths.

1. PRESENTATION
on
Voluntary Surgical sterilization
1

2. Estimated Time:
25 min
Presentation slide:
31
Group Member
Manisha Basnet
Babita kattuwal
Kaberi jha
Rabin Dani
Bikas Pudasaine
Sudip Thapa
Sasi kiran Devkota
Bhojan Dhakal
2

3. ∗ Introduction
∗ Objectives
∗ Mode of action
∗ Advantage / Disadvantage
∗ Side effects
∗ Indication / Contraindication
∗ Availability
Presentation plan
3

4. ∗Voluntary Surgical sterilization is the permanent
method of family planning for men and women who
are sure that they will not want more children .
 For men
- Non Scalpel Vasectomy (NSV)
 For women
- Minilap
- Laparoscopy
Voluntary Surgical sterilization
4

5. VASECTOMY
Introduction
vasectomy is a surgical procedure performed on males in which the
vasa differentia (tubes that carry sperm from the testicles to the seminal
vesicles) are cut, tied, cauterized (burned or seared), or otherwise
interrupted.
The procedure is done under local anesthesia and takes only 15-
20 minutes. There is no need of any overnight stay.
 Now a days non scalpel or key hole vasectomy is done which don’t
required stitch.
Fully effective only after 20 ejaculations or 3 months. The man should
use condoms or his partner should use another method until then.
Vasectomy is 99.99% effective as birth control
Vasectomy
5

6. Background
NSV originally developed in China in 1974 and first introduced
in the United States in 1984,
 In Nepal it was started in 1992 and the training as such
started in 1996.
Vasectomies are 99.99% successful in preventing conception.
The semen no longer contains sperm after the tubes are cut,
so conception cannot occur. The testicles continue to produce
sperm, but they die and are absorbed by the body.
Non scalpel vasectomyVasectomy
6

7. ∗ To avoid unwanted birth.
∗ To make family life healthy
Objectives
7

8. Stripping of fascia to expose loop of vasANESTHESIA
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9. Cut and closed tubes
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10. The health care provider makes a small opening in
the man's scrotum (the sac of skin that holds his
testicles) and closes off both tubes that carry sperm
from his testicles. This keeps sperm out of his semen.
The man still can have erections and ejaculate
semen. His semen no longer makes a woman
pregnant, however, because it has no sperm in it.
How does it work ? (MoA)
10

11. ∗ Permanent, A single quick procedure leads to lifelong,
safe and very effective family planning.
∗ No fear about pregnancies.
∗ Vasectomy is a safer, procedure that causes fewer
complication than tubal ligation in female.
∗ No need to worry about using other birth control methods
∗ Vasectomy is cheaper and fewer complications than tubule
sterilization.
Advantages
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12. ∗ It does not protect against sexually transmitted infections.,
including HIV.
∗ Not immediately effective. The first 20-30 ejaculations after
vasectomy may contain sperm. The couple must use another
contraceptive method for the first 20-30 ejaculations or the first
3 months.
∗ Common minor short-term complications of NSV :
- Usually uncomfortable for 2 or 3 days,
- Pain in the scrotum, swelling and bruising (emotionally
feel injured)
∗ The man who wants to open a vasectomy can be done in a
way that is reconnect the channel sperm, but the small
chances of success
Disadvantages
12

13. Rarely:
∗Bleeding under the skin, which may cause swelling.
∗Infection at the side of the incision.
∗Pain, fever.
Side Effect
13

14. ∗ The client who seeks permanent method and wants no
more children.
∗ The client should be above the age of 22 years and below
the age of 49 years. However, with adequate counseling
there is no age restriction.
∗ There should be at least 2 living children. However, with
adequate counseling there is no parity restriction.
Indication of NSV
14

15. ∗ Any problems with genitals such as infection,
swelling, injuries, lumps in penis or scrotum.
∗ Some other serious conditions or infections.
Contraindication
15

16. Common Myth in NSV
NSV can loose sexual desire:
vasectomy will not affect a man’s sex life or production of
male hormones. Following a vasectomy a man will continue
to enjoy sex and produce the same amount of semen when
he ejaculates but the semen will not contain sperm that can
impregnate a woman.
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17. Female Sterilization
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18. Introduction
 Minilap tubectomy, generally referred to as “Minilap” is a surgical
approach to the fallopian tubes by means of an incision 2-5 cm in
length., It has been performed safely and frequently in a wide.
 It is a safe and simple surgical procedure. It can usually be done
with just local anesthesia. Proper infection-prevention procedures
are required.
 Female sterilization is a form of contraception that involves
cutting or sealing the Fallopian tubes.
 Minilap is the most common used method of family planning.
 Female sterilization are 99.5% effective as birth control.
Minilap
18

19. ∗ Female sterilization was firstly used in the 19th
century
by James Blundell.
Background
19

20. ∗ To provides permanent contraception for women who
will not want more children.
∗ Improve overall reproductive health of individual and
couples.
∗ Reduce Total Fertility Rate
Objectives
20

21. Female Sterilization
21

22.  Sterilization usually
involves 1 small incision
just below the navel
Fig : Minilaparotomy for
female.
 Minilaparotomy for
female sterilization
involves a small incision
just above the pubic hair.
Fig : Laparoscopy
for female
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23. ∗ The health care provider makes a small incision in the
woman's abdomen and blocks off or cuts the 2 fallopian
tubes. These tubes would carry eggs from the ovaries to
the uterus. With the tubes blocked, the woman's egg
cannot meet the man's sperm. The woman continues to
have menstrual periods.
Minilap
How does it work? (MoA)
23

24. ∗ Very effective.
∗ Helps protect against:
- Risks of pregnancy
- Pelvic inflammatory disease (PID)
∗ May help protect against:
- Ovarian cancer
∗ No interference with sex. Does not affect a woman's ability to
have sex.
∗ Increased sexual enjoyment because no need to worry about
pregnancy.
Advantages
24

25. ∗ No protection against sexually transmitted infections (STI)
including HIV.
∗ Usually painful at first, but pain starts to go away after a
day of surgery.
∗ Uncommon complications of surgery:
- Infection or bleeding at the incision,
- Internal infection or bleeding,
∗ Pregnancies among users of voluntary sterilization are few.
But when pregnancy occurs, it is more likely to be ectopic
than the average pregnancy.
Disadvantages
25

26. Rarely:
∗Infection at the side of the incision.
∗Bleeding under the skin, which may cause swelling.
Side effects
26

27. Interval Minilap may be performed: During menstruation, or
within 5 days of LMP or any time in the menstrual cycle if client is
known to be not pregnant.
The client seeks permanent method and wants no more
children.
The client should be above the age of 22 years and below the
age of 49 years. However, with adequate counseling there is no
age restriction.
There should be at least 2 living children. However, with
adequate counseling there is no parity restriction.
Do not need to have husbands/guardians permission.
Indication
27

28. Women who wants give birth to other baby.
Some other serious conditions or infections.
Contraindication
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29.  Does not make women weak.
∗ Does not cause lasting pain in back, uterus, or abdomen.
∗ Does not remove a woman’s uterus.
∗ Does not cause hormonal imbalances.
∗ Does not cause heavier bleeding or irregular bleeding or
otherwise change women’s menstrual cycles.
∗ Not cause any changes in weight, appetite, or appearance.
∗ Does not change women’s sexual behavior or sex drive /
desire.
Correcting Misunderstandings
29

30. ∗ At least one type of VSC service was made
available in all districts except Ilam and Manang
through hospitals , family planning association
Nepal and mobile outreach services. VSC mobile
outreach program was conducted in 73 districts in
FY 2069/70.
Availability of surgical sterilization

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