Tubal ligation is a procedure where the fallopian tubes are disconnected from the uterus. How is it done? Is it safe? And when is it considered?
A Tubal ligation procedure; is a procedure where the tubes are disconnected from the uterus. This can be done surgically through blocking, tying or cutting through the tubes during surgery. This is a permanent birth control method. It prevents the sperm from reaching the oocyte and fertilizing it.
What is Tubal Ligation?
Tubal ligation is a surgery to close the fallopian tubes in a woman as a permanent form of birth control. This procedure stops the oocyte (egg) from traveling from the ovary through the fallopian tubes to the uterus and the spermatozoa from reaching it thus preventing pregnancy. Tubal ligation can be performed by several surgical methods.
Tubal ligation also commonly known as “tying your tubes” or “tubal sterilization” is a procedure that does not affect the menstrual cycle. The tubal ligation can be performed at any time including right after birth. Tubal ligation can be done via laparoscopy, hysteroscopy, laparotomy or colpotomy. The method of choice will depend on your surgeon and your general health. If you choose to ligate your tubes right after delivering of course apart from surgeon’s choice and your general health the mode of delivery is added to the equation, it would make sense of course that if you deliver via a cesarean section that they are instantly tied through the cesarean incision.
Tying your tubes is a procedure that is difficult to reverse.
What happens in a Tubal ligation procedure?
Tubal Ligation surgery is the disconnecting of the fallopian tubes and can be done through several ways
- Hysteroscopic Tubal Ligation; through the hysteroscope heat can be applied to the tubal openings in the uterus and cauterize (seal) them thus disconnecting the tubes.
- Laparoscopic Tubal Ligation is less invasive than tying your tubes through open abdominal surgery. It is done by inserting a thin tube called a laparoscope through a small incision near the navel area, the surgeon then makes a small second incision to reach the fallopian tubes. The fallopian tubes can be disconnected by cutting through them, cauterizing them, by placing a band or tying a suture around them.
- Laparotomy; Tubal ligation through a laparotomy is usually done after a caesarean section (CS) through the CS incision the tubes can then be disconnected by the same options mentioned in the laparoscopic tubal ligation.
- Tubal ligation through Colposcopy is a method that isn’t frequently used anymore. A small incision is made in the back of the vaginal wall to expose the fallopian tubes, they are pulled into the vagina and then disconnected by cutting them, cauterizing them, placing a band or suturing them. The fallopian tubes are then placed back, and the back vaginal wall incision sutured.
Risks of Tubal ligation surgery
Disconnecting the fallopian tubes through any of the above-mentioned methods is a safe procedure but it requires incisions usually made under general anesthesia, which may be associated with the following risks:
- Bleeding.
- Infection.
- Side effects of anesthesia like headache and nausea.
- Incomplete closure of fallopian tube, which may lead to unwanted pregnancy or ectopic pregnancy in the future
Why women make the choice of Tubal ligation?
Tubal ligation surgery is an effective permanent method of contraceptive surgery. It will for 99 percent protect you against unwanted pregnancies. It must be noted that even though it is effective in preventing unwanted pregnancies it by no means shields you from sexual transmitted diseases (STDs). So always use extra protection like a condom.
Tubal ligation or “tying your tubes” can also reduce your risk of ovarian cancer, especially if the fallopian tubes have been removed. This is an added advantage of tubal ligation but by no means is done for just this reason! It is believed it can reduce the risk of ovarian cancer by preventing the passage of tubal cells to the ovary and by the collateral damage to the tubal blood supply which effects the tubal epithelium.
Bedaya Hospital advises you to talk to your doctor or healthcare provider to make sure you fully understand the risks and benefits of this procedure before undergoing it we also advice you to consider other options like an IUD or a quarterly subcutaneous contraceptive implant.
Tubal ligation side effects
Tubal ligation is a surgery involving incisions in the abdomen which require anesthesia either local or general. Following are some of the complication even if rare to consider before doing the procedure;
- Damage to the intestines, bladder or main blood vessels.
- Reaction to anesthesia.
- Infection or inappropriate healing of incision wounds.
- Persistent abdominal or pelvic pain.
- The procedure fails, resulting in unwanted pregnancies in the future
Factors that increase your complication risks during tubal ligation surgery include:
- History of abdominal or pelvic surgery
- Obesity
- Diabetes
Pregnancy after tubal ligation
Tying your tubes usually results in a permanent form of contraception but in 1 of every 200 women that have undergone this procedure pregnancy occurs, it sometimes happens when the tubal ends connect again over time, or if the procedure was unsuccessfully done by the surgeon.
Women may change their minds after the procedure, in this case the two channels can be reconnected through a reverse surgery, but the proportion of women where fertility is restored after this procedure ranges from only 50% to 80%, so having your tubes tied is mostly treated as a final form of contraceptives.
It should be noted that the process of tying the fallopian tubes at the trumpets (dilated end near ovary) increases the risk of ectopic pregnancy, and any woman undergoing this type of tubal ligation should be made fully aware of the signs and symptoms that may indicate the occurrence of this type of pregnancy.
