Tubal Ligation

Is the surgery to close the fallopian tubes of a woman. These tubes connect the ovaries to the uterus. A woman undergoing this surgery can no longer get pregnant ( sterile).

Description

Tubal ligation is done in a hospital or in an outpatient clinic .

You can put him general anesthesia , which will make you unconscious and unable to feel pain. Or you may have local anesthesia (awake and unable to feel pain) or spinal anesthesia ( awake but unable to feel pain). Also, you probably will be given medicine to induce sleep. The procedure takes about 30 minutes.

The surgeon will make one or two small surgical incisions in the abdomen, usually around the navel. Gas can be pumped into the abdomen to expand , which helps the surgeon to see the uterus and fallopian tubes. The surgeon will insert a laparoscope, a narrow tube with a tiny camera on the end , in the abdomen. Also, instruments are introduced to block the tubes through the laparoscope or through a small separate incision . The tubes are cauterized (burned ) or clamped with a small clip or ring ( band) .

Tubal ligation can also be done right after having a baby through a small incision in the navel or during a cesarean.

Another method of sterilization involves going through the cervix and placing coils or plugs in the tubes where they connect with the uterus ( hysteroscopic procedure tubal occlusion ) .

Why is this procedure performed

Tubal ligation may be recommended for adult women who are certain that they do not wish to become pregnant in the future.

While many women choose to have tubal ligation, some are sorry later that you did. The younger the woman, the more likely they regret having her tubes tied as she gets older.

Tubal ligation is considered a permanent form of family planning method is not recommended as short-term or reversible. Still, sometimes major surgery can be reversed. Approximately 50 to 80 of every 100 women who undergo tubal ligation reversed are able to become pregnant. A method of hysteroscopic tubal occlusion is very difficult to reverse.

Risks

Risks for any surgery are:

Bleeding.
Damage to other organs (digestive or urinary systems), which requires additional surgery to repair.
Infection.

Risks for any anesthesia include:

Allergic reactions to medicines.
Breathing problems or pneumonia.
Heart problems.
Risks for tubal ligation are:

Incomplete closure of the tubes, which may even make it possible to present pregnancy. About 1 in 200 women who have had tubal ligation get pregnant later.
Increased risk of tubal (ectopic) pregnancy if pregnancy occurs after a tubal ligation.
Injury to adjacent organs or tissues caused by surgical instruments.

Before the Procedure

Always tell your doctor or nurse:

If you are or could be pregnant .
What drugs you are taking, even drugs , supplements, or herbs you bought without a prescription .

During the days before the surgery :

You may be asked to stop taking acetylsalicylic acid ( aspirin ), ibuprofen ( Advil , Motrin ), warfarin (Coumadin ), and any other drugs that make it hard for blood clotting .
Ask your doctor which drugs you should still take on the day of surgery .
If you smoke , try to quit . Ask your doctor or nurse to quit.
If they are performing the procedure of tubal occlusion , ask you to take a hormone for at least two weeks before surgery .

On the day of surgery :

Will usually be asked not to drink or eat anything after midnight the night before surgery or 8 hours before the time of surgery .
Take the drugs your doctor told you to take with a small sip of water .
The doctor or nurse will tell you when to arrive at the hospital or clinic.

After the procedure :

You will probably go home the same day of the procedure . Some women may need to stay in hospital overnight .

You have some tenderness and pain. The doctor will give you a prescription for pain medicine or tell you what counter painkillers can take.

After laparoscopy, many women will have shoulder pain for a few days, which is caused by the gas used in the abdomen to help the surgeon see better during the procedure. You can leave the sleeping gas .

You should avoid heavy lifting for 3 weeks , but may return to most normal activities within a few days .

If you practice the procedure hysteroscopic tubal occlusion will need to continue to use birth control until you have a test three months after the procedure to check if it worked.

Forecast :

Tubal ligation is an effective form of birth control for women and most of them have no problem . You do NOT need to have any tests to confirm that you can not get pregnant in the future if the procedure is done with laparoscopy or after giving birth to a baby .

If you practice the type of sterilization through the uterus ( Essure or Adiana ) , you will need to have a test called hysterosalpingogram three months after the procedure to make sure the tubes are blocked .

Your menstrual cycles will return to the pattern that is normal for you. If you used hormonal contraceptives, or the Mirena IUD before, then your periods will change to whatever is normal for you after you stop using these methods.

Women who undergo a tubal ligation have a decreased risk of ovarian cancer later .

Alternative names :

Female sterilization surgery , tubal sterilization , tubal ligation ; Tying the tubes ; procedure hysteroscopic tubal occlusion

References
Mishell DR Jr. Family planning: contraception, sterilization, and pregnancy termination. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 14.