Tubal ligation
Tubal ligation

Tubal ligation

Definition:
A tubal ligation is a surgery to "tie the tubes" (fallopian tubes) of a woman which causes permanent sterility by preventing transport of the egg (ovum) to the uterus, and by blocking the passage of sperm up the tube to the ovulating ovary where fertilization normally occurs.

Alternative Names:
Sterilization surgery - female; Tubal sterilization

Description:

Tubal ligation is done in the hospital or in an outpatient surgical clinic while the patient is under anesthesia. One or two small incisions are made in the abdomen (usually near the navel), and a device similar to a small telescope on a flexible tube (called a laparoscope) is inserted.

Using instruments that are inserted through the laparoscope, the tubes (fallopian tubes) are coagulated (burned), sealed shut with cautery, or with a small clip placed on the tube. The skin incision is then stitched closed. The patient is able to return home within a few hours after the procedure.

Tubal ligation can also be performed immediately after childbirth through a small incision near the navel or during a cesarean section.

Indications:

Tubal ligation may be recommended for adult women who are certain that they wish to prevent future pregnancies (permanent sterilization). Keep in mind that tubal sterilization is not a trivial surgical procedure, and that it carries some risk.

While sterilization is very popular, many women who choose to have the procedure regret their decisions later. The younger the woman, the more likely it is that she will regret her decision.

Tubal ligation is not recommended as a temporary or reversible procedure -- it is considered a permanent form of birth control. The operation can sometimes be reversed if a woman later chooses to become pregnant, however this requires a major surgical procedure. Following tubal ligation reversal, about 50% to 80% of women eventually become pregnant.

Risks:
Risks for any anesthesia are: Risks for any surgery are: Additional risks for tubal ligation include:
  • Incomplete closure of the tubes and possible fertility. The pregnancy rate after tubal ligation is about 1 out of 200 women.
  • If pregnancy does occur after a tubal ligation, there is an increased risk that it will be an ectopic (or tubal) pregnancy.
  • Injury to adjacent organs or structures caused by the laparoscopic instruments.
Expectations after surgery:
Most women recover with no problems. There are no tests required to verify sterility.
Convalescence:
Most women are advised to avoid strenuous exercise for several days. Oral pain medications can usually manage the pain. Most women are able to return to work within a few days. Sexual intercourse can be resumed as soon as the patient feels ready (usually within a week).

Review Date: 1/30/2002
Reviewed By: Catherine S. Bradley, M.D., Department of Obstetrics & Gynecology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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