Sterilization

Abstract

Sterilization is permissable in any woman in whom pregnancy will aggravate existing disease which is not amenable to direct cure, undo previous corrective gynecology or jeopardize her life. Written consent from both husband and wife should be obtained. Sterilization is urgently desirable in women with certain types of mental disease and congenital defects. For permanent sterilization by surgical methods “tubal crushing” (Walthardt) and cornual excision as described, are the simplest and surest of all the available methods. When surgery is contraindicated, permanent sterilization can be obtained with either x-ray or radium therapy. This always involves destruction of ovarian function and onset of the menopause. Temporary sterilization by surgical methods is usually a failure. Irradiation for this purpose is unreliable and fraught with the risk of producing permanent sterilization. Contraception is the logical procedure if pregnancy is to be avoided temporarily. The combined indication for sterilization and therapeutic abortion occurs in approximately 13 per cent of patients requiring sterilization. Abdominal hysterotomy by a transverse fundal incision which includes cornual excision is the operation of choice. Biological methods for the attainment of sterilization are still entirely experimental. The only one that holds any hope in the future is the utilization of spermatoxins.