Sections View Full Chapter Figures Tables Videos Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 18-21: Contraception + Key Features Download Section PDF Listen +++ ++ In the United States, sterilization is the most popular method of birth control for couples who want no more children Vasectomy is a safe, simple procedure in which the vas deferens is severed and sealed through a scrotal incision under local anesthesia Female sterilization is performed via Laparoscopic bipolar electrocoagulation Salpingectomy Plastic ring application on the uterine tubes Minilaparotomy with tubal resection Hysteroscopic transcervical sterilization The cumulative 10-year failure rate for all methods combined is 1.85%, varying from 0.75% for postpartum partial salpingectomy and laparoscopic unipolar coagulation to 3.65% for spring clips Two methods of transcervical sterilization, Essure and Adiana, can be performed as outpatient procedures Essure Involves the placement of an expanding microcoil of titanium into the proximal uterine tube under hysteroscopic guidance Efficacy rate at 1 year is 99.8% Adiana Involves hysteroscopically-guided superficial radiofrequency damage to the tubal lumen and immediate placement of a nonabsorbable silicone elastomer matrix in the tube to allow tissue in-growth Efficacy rate at 1 year is 98.9% Both procedures should have tubal occlusion confirmed at 3 months with a hysterosalpingogram