Vincent Mazzarella, MD

There are several mandatory steps required before obtaining the laparoscopic tubal ligation type of sterilization.

1. A formal consent (en español) must be signed more than 30 days before any sterilization procedure is performed. This consent must be accompanied by counseling (regarding the alternative methods of birth control as well as the risks of the sterilization procedure) by a qualified practitioner, and the practitioner who provides this counseling must also sign the consent form indicating that the counseling has been provided. The intent of the waiting period between counseling and a sterilization procedure is to give ample opportunity for consideration of the procedure. For the most part, sterilization procedures are permanent.

Many women's health clinics and family planning clinics have practitioners that are able to provide the appropriate counseling (regarding sterilization and alternatives) for you and obtain the consent at the same time. This is acceptable, as long as the consent form with the original signatures (not a copy) is mailed to Dr. Mazzarella's office well in advance of the procedure. If your women's health center/family planning facility does not have the consent form available to them, one can be downloaded here (en español), or we are happy to fax a blank one. This must then be filled out, signed, and mailed back to us.

A Patient Information Booklet (en español) regarding sterilization and alternatives is also generally provided at the time of counseling, for your reference.

In you choose, Dr. Mazzarella can provide the counseling to you via a Telemedicine consult (if you have a webcam-capable computer with Skype or other video-conferencing software). However, because no insurance company pays for this service, there is a cash fee (payable by credit card or PayPal) required for this service. (The fee is probably less than a tank of gas, if you live any significant distance from the clinic.) The consent form can then be downloaded (as referenced above), or can even be faxed or mailed to you. You would complete the form, sign it, and then mail it back to us (we must have an original signature, not a fax or a copy).

2) If you have had prior abdominal operations (including C-sections), there are some particular risks to the operation which should be discussed in advance. Specifically, prior abdominal operations can leave scar tissue ("adhesions") within the abdomen that can interfere with tubal ligation. Much of Dr. Mazzarella's general surgical practice has included division ("lysing") of this scar tissue, so this service can be provided at the same time, but you must discuss this personally with him (either by Telemedicine or in the clinic), first. Also, if you have or have had any medical problems or concerns, you ought to discuss them with him first, as well. (Women's health clinics and family planning clinics usually do not have have detailed knowledge about operative issues.)

3) You are required to have a pre-operative physical and examination by Dr. Mazzarella prior to any operative procedure. Dr. Mazzarella routinely provides this in the clinic during the week before the procedure. However, if you live a long distance from the clinic and have had a direct consultation with him at least once (by Telemedicine, telephone, or other method), this can be done on the same day as the procedure, immediately preceding it.

4) Although the risk of bleeding from this procedure is minimal, aspirin, ibuprofen, naproxen and similar anti-inflammatories can cause a bit of bleeding. Please do not take these medicines for 1 week prior to any procedure. (Tylenol / acetaminophen is ok).

If you are taking an anti-coagulant ("blood thinner") such as Plavix, Lovenox, or Coumadin for any reason, you must have a personal evaluation in the clinic prior to scheduling any operative procedure.

5) General anesthesia is required for the procedure. If you have concerns about anesthesia or a personal or family history of anesthesia problems, you must have a personal evaluation in Dr. Mazzarella's clinic prior to scheduling any operative procedure.

An empty stomach is required for 8 hours prior to general anesthesia. Do not eat or drink anything for 8 hours beforehand. If this is a problem, if you are diabetic, or if you have medicines that must be routinely taken, you must discuss this with Dr. Mazzarella personally prior to the day of the procedure (in person, by Telemedicine, or by telephone).

6) Do not schedule the procedure if you are sick, have or have had any recent wheezing or other respiratory problems, or have any serious concerns.

You must have someone drive you to and from the procedure. The anesthetic does not always immediately wear off completely, and it could become dangerous to drive yourself home were a small amount of it to remain in your body and you were to become dizzy while driving.

7) Recovery following the procedure is quick. The anesthetic normally wears off within an hour, and you can go home within 1-2 hours. Pain medicine is usually not needed afterwards, and there are no activity restrictions, in general. There is no waiting period for sexual relations, either. Other websites state that recovery takes 1-2 weeks and heavy lifting is recommended against, but this is not true. You can resume almost all activities without limitation almost immediately.

Questions? Call the clinic at (530) 458-3243.

More resources and counseling regarding birth control methods:

* Patient information: Birth control; which method is right for me? (UpToDate)
* Birth Control (National Institutes of Health)
* Birth Control Guide (Mayo Clinic)
* Los Anticonceptivos, en Español (Colegio Americano de Obstetras y Ginecólogos)
* Tomar la decisión para una cirugía de esterilización (Institutos Nacionales De la Salud)
* Esterilización, Esta hoja informativa (Womenshealth.gov)