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| Physicians performing - tubal ligation |
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| Tied Tubes... |
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A tubal ligation is a form of female sterilization that is among the most effective methods of permanent birth control. They are generally safe, and recovery time is relatively brief. Although the procedure can be reversed, this is not always successful. In addition, the risk of having an ectopic pregnancy (pregnancy that develops outside the uterus) rises after the reversal of a tubal ligation. For this reason, a woman should be sure she no longer wants to have children before she has a tubal ligation. Tubal ligations are generally performed:
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After childbirth or an abortion. Some pregnant women decide before delivery or before having an abortion to have their tubes tied during the same hospital procedure. |
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As a separate procedure. Usually performed with a thin instrument called a laparoscope, which is introduced to the body through a small incision. A new procedure called Essure is performed through the vagina. |
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Before and during the tubal ligation
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Day before surgery --
You may be given a laxative the evening before or in the morning before surgery. There may be dietary restrictions (such as: Do not eat or drink anything after midnight) or changes to a medication regimen.
The tubal ligation is performed with general anesthesia and the patient will be asleep during the procedure. In other cases, a local anesthetic will be used. Either way, arrange to have someone drive you home from the hospital |
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Methods used --
If you have had a vaginal delivery, the physician is likely to perform a minilaparotomy. A small incision (1 to 3 inches long) is made below the navel, and the physician raises a portion of each fallopian tube. The pathway through the fallopian tubes will then be blocked in some fashion. This is usually done by cutting the tube and sealing each end.
A separate procedure is laparoscopic sterilization, where the patient’s abdomen is inflated with gas (carbon dioxide), which helps the surgeon locate the fallopian tubes. A small incision is made below the navel, and a laparoscope is inserted into the abdomen. Instruments are inserted into the |
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same incision or a separate incision and the tubes are either cut and tied, cauterized (use of heat to form an electric current to fuse the tubes) or closed with plastic clips or rings. In some cases, a small piece of each tube is removed. This procedure is often performed on an outpatient basis.
A new procedure called the Essure procedure is the most recent sterilization technique to receive approval from the Food and Drug Administration (FDA). In this procedure, a catheter is used to introduce a soft, flexible metallic micro-insert through thevagina and into each fallopian tube. Within three months, scar tissue forms around the micro-insert and blocks off the fallopian tube. The entire procedure can be completed within 35 minutes and does not require any incisions. Three months after this procedure, the patient is required to have a procedure called a hysterosalpingogram, a dye test to assure that the tubes are blocked. |
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You will likely experience soreness in your abdomen. This can usually be treated with a mild pain reliever. Other side effects of the procedure include dizziness, fatigue, bloating and nausea. If you had a laparoscopic tubal ligation you may experience discomfort in the shoulder or side of the neck as a result of the gas that is used to inflate the abdomen. Within eight hours, most women feel strong enough to walk around and eat food, as well as to care for their infant if they have just had a baby.
Most side effects that accompany tubal ligation should disappear within one to three days, but you should refrain from heavy lifting for about a week. Alert your doctor if you experience any of the following symptoms:
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Pelvic infection
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Reaction to the anesthetic
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Injury to blood vessels in the abdomen
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Injury to the bowel or bladder
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Burns resulting from cauterization
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| Women having the procedure done early in their reproductive years have reported a failure rate of 5 percent during the first decade after the surgery. If you get pregnant after a tubal ligation you are at higher risk for an ectopic pregnancy. An ectopic pregnancy may occur as many as 10 years after tubal ligation. Symptoms of an ectopic pregnancy include: |
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Severe pain in one or both sides of the lower abdomen
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Abdominal pain and spotting, particularly after a missed or light period
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Feelings of faintness or dizziness
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