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DESCRIPTION
A method of sterilization that involves blocking the fallopian tubes in a way that the ovum (egg) is inaccessible for sterilization.
Fallopian Tube Anatomy
Tubal Ligation & Resection: Pomeroy Procedure
Tubal Ligation: Tubal Ring or Tubal Clip
Tubal Ligation: Coagulation Methods of Tubal Ligation
Tubal Ligation: Parkland & Irving Methods
Tubal Ligation: Fimbriectomy
Female Sterilization Using Other Methods:
MoonDragon's Contraception Information: Tubal Ligation
Discusses female sterilization using:
- Hysteroscopic Tubal Sterilization with the Essure System
- Quinacrin Pellet Sterilization (Q Method)
REASONS FOR PROCEDURE
Prevention of unwanted pregnancy. It is important to receive professional counseling before deciding to undergo this surgery. Sterilization is considered a permanent form of birth control, although in some cases it can be reversed.
Information about tubal ligation reversal can be found at this website:
Tubal Ligation Reversal Preview for Modem (0.99 Mb)
Tubal Ligation Reversal Preview for DSL/Cable (5.36 Mb)
Tubal Ligation Reversal Preview for Media Player
RISK INCREASES WITH
Obesity; smoking; poor nutrition.
Recent or chronic illness.
Use of drugs such as antihypertensives; muscle relaxants; tranquilizers; sleeping pills; insulin; sedatives; beta-adrenergic blockers; or cortisone.
Use of mind-altering drugs, including narcotics, psychedelics, marijuana, sedatives, hypnotics or cocaine.
DESCRIPTION OF PROCEDURE
The procedure may be performed in a hospital or outpatient surgical facility.
A local anesthetic by injection, a spinal anesthetic by injection or a general anesthetic may be administered.
One of several techniques is used to expose the fallopian tubes for surgery:
- Laparoscopy - is the most common procedure. It involves the use of a telescopic instrument with fiberoptic light and generally requires a pencil-sized incision above the pelvic bone.
- Mini-laparoscopy - involves an approach through an incision just below the umbilicus (belly button). This approach is favored in women having the tubal ligation immediately following delivery.
- Posterior colpotomy - less often used. It is an approach through the rear of the vagina.
Once the fallopian tubes are exposed, a small section of each tube is cut free and removed. The severed ends are tied (ligated), blocked or coagulated using an electric current. In some cases, the tubes are clamped off using a clip or band. When the procedure is a laparoscopy, the operation is performed inside the abdomen with the appropriate instruments. With a laparotomy, the tubes are handled directly and a segment is generally removed.
A laparotomy, which requires a standard surgical incision through the abdomen, is a more complicated method of tubal ligation and is usually reserved for cases where other methods have failed, there is scarring from previous surgery, or the laparotomy is necessary for another condition.
If an incision was made, the skin is closed with sutures or clips, which usually can be removed about 1 week after surgery. Often, the sutures used are absorbable and don't need to be removed.
EXPECTED OUTCOME
Expect complete healing without complications and sterility for life. Your menstrual periods will continue as usual. Allow about 2 weeks for recovery from surgery.
Women who have had heavy periods prior to the operation will continue to have heavy periods.
Women who have been on the pill (oral contraceptives) for a long time may find that the added benefits of the pill require that they remain on it after their tubal ligation.
POSSIBLE COMPLICATIONS
Inadvertent injury to surrounding structures.
Infection or bleeding.
Failure of the sterilization procedure (about 1% or less for all techniques). This may result in an ectopic pregnancy.
POST-PROCEDURE CARE
GENERAL MEASURES
With most procedures, you will be allowed to return home the same day.
Use an electric heating pad, a heat lamp or a warm compress to relieve surgical wound pain.
Bathe and shower as usual. You may wash the incision gently with mild unscented soap.
Use another method of birth control until the next menstrual period to make sure an egg has not passed the point where the tubes were blocked.
Consider psychological counseling if you feel sad or depressed after the surgery.
MEDICATION
Prescription pain medication should generally only be required for 2 to 7 days following the procedure.
You may use non-prescription drugs, such as acetaminophen, for minor pain.
Stool softener laxative, if needed to prevent constipation.
Antibiotics to fight infection.
ACTIVITY
Return to daily activities and work after one week.
Avoid vigorous exercise for 2 weeks after surgery.
Resume driving 3 days after returning home.
Sexual relations may be resumed when your health care provider has determined that healing is complete.
DIET
No special diet, no restrictions. However, you should follow a healthy, balanced nutritional program for a healthy immune system and to assist in a rapid recovery from your surgery.
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
The following occurs after a tubal ligation:
You have pain, swelling, redness, drainage or bleeding increases in the surgical area.
You develop signs of infection: headache, muscle aches, dizziness, or a general ill feeling and fever.
You experience nausea, vomiting, constipation or abnormal swelling.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
-- by Phyllis A. Balch, James F. Balch
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