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Tubal ligation is a surgery for a woman in which her fallopian tubes are closed. This surgery prevents the sperm from reaching an egg. Tubal ligation is for women who do want to become pregnant. This surgery is for permanent sterilization.
A woman who has this surgery can still ovulate and menstruate. But the cut or blocked tubes keep the egg and sperm from meeting. When the egg and sperm cannot come together, fertilization doesn't happen and pregnancy cannot occur. This surgery is not recommended as a temporary or reversible procedure.
If you are making this decision as a couple, talk to your partner about considering a
vasectomy. A vasectomy, compared to tubal ligation, has fewer serious complications. Although minor complications are common.
Your doctor will likely do the following:
- Physical exam
- Discuss your reason for this procedure
- Pregnancy test
In the time leading up to your procedure:
- The night before, eat a light meal and do not eat or drink anything after midnight.
- Wear loose-fitting clothing.
- General
or local
anesthesia
- General or spinal anesthesia for laparotomy
There are two main methods of tubal ligation, and one less common method.
The doctor begins by making a small cut in the area of navel, through which she injects a harmless gas into your abdomen. The gas inflates the abdominal cavity. This makes it easier to see the internal organs. The doctor then inserts a long, thin tool (called a laparoscope) that contains a small lens and lighting system. The tool magnifies and illuminates the structures inside your lower abdomen. She may make a second cut just above the pubic hair to insert a tool for grasping the fallopian tubes. The tubes are closed by one of the following ways:
- Tying and cutting (ligation)
- Sealing by creating scar tissue
- Removing a small piece of the tube
- Applying plastic bands or spring-loaded clips
The tools are then removed and the openings closed with stitches. The surgery can be done in outpatient surgical clinics. There is very little scarring. You may go home the same day. You may have sexual intercourse as soon as you feel comfortable. Injury to the bowel or bleeding inside the abdomen occurs in five out of 1,000 cases. Major surgery may be needed to fix this. For this procedure, there is no gas or laparoscope. It is typically done soon after childbirth. The doctor makes a small cut just above the pubic hair, or if done within 48 hours of childbirth, below the navel. The doctor uses a small tool to tie, clip, or seal off the tubes. You should heal in a few days.
Your doctor will tell you when you can resume sexual intercourse. Other surgical therapies: This is a major surgery. It is less commonly used than mini-laparotomy and laparoscopy.
The surgeon makes a 2-5–inch cut in your abdomen.
She closes off the tubes.
You may need to be in the hospital for 2-4 days.
It may take several weeks at home to completely recover.
If the procedure is done after delivery, your hospital stay may be extended by one or two days.
When to resume sexual intercourse depends on your recovery rate. Rest in the recovery room for about an hour with local anesthesia, perhaps longer if a general anesthetic was given. Anesthesia prevents pain during surgery. Depending on which type of surgery you have, you may have some pain during recovery. Your doctor will give you pain medication to relieve discomfort. You may feel bloated or have pain in the shoulder or chest. This is due to abdominal gas, which may last for up to three days. Try walking, a heating pad, or a warm shower to decrease the discomfort.
Complications may develop in 1%-4% of sterilizations performed through the abdomen, and in 2%-13% of sterilizations performed through the vagina. Deaths resulting from tubal sterilization are extremely rare. Possible complications include:
- Infection
- Bleeding
- Anesthesia-related problems
- Injury to the bowel or bladder
-
Pregnancy related to operative failure or rejoining of the fallopian tubes (occurs in about one out of 400 women)—If pregnancy occurs, there is an increased risk of
ectopic pregnancy.
- You can remove the operative dressings the morning after surgery and the small paper strips after 2-3 days.
- Do not drive or drink alcohol for 24 hours.
- Do not lift anything heavy or perform hard labor for at least a week.
- If you are nauseous, try eating tea, toast, or crackers.
- Avoid sexual activity for at least one week, or as long as your doctor recommends.
After you leave the hospital, call your doctor if any of the following occurs: - Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
- Severe and continuous abdominal pain
- Cough, shortness of breath, chest pain, or severe nausea or vomiting
- Fainting or dizziness
- Nausea and vomiting lasting more than a day
- Heavy vaginal bleeding after the first day
- Missed menstrual period
Last reviewed January 2008 by Jeff Andrews, MD Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition. Copyright © EBSCO Publishing. All rights reserved. |
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