Tubal Ligation is also known as Tubal Sterilization or getting your tubes tied which is a kind of permanent birth control. The fallopian tubes are blocked or cut during tubal ligation in order to permanently prevent pregnancy. Effectively, tubal ligation disrupts movement of egg to uterus for purpose of fertilization while blocking sperms from traveling up fallopian tubes so as to inseminate the ovum. However, tubal ligation does not disturb or effect the menstruation cycle. Women can undergo tubal ligation at all ages, including after childbirth or in combination with some other abdominal surgical intervention like C-section. Moreover, it is also possible to reverse tubal ligation procedure, but the reversal process is a major surgery which may not always be effective.
One of the most commonly performed surgical sterilization technique for women around the world tubal ligation permanently prevents pregnancy & thereby ends the need to undertake any other type of contraception method. Tubal ligation is also helpful in decreasing risk of developing ovarian cancer in women. Nevertheless, this sterilization procedure is not the most appropriate treatment for everyone. Doctors or gynecologic surgeons will make sure that patients fully understand risks & benefits of tubal ligation before undergoing this procedure. Doctors may also talk to patients about other options during consultation, like hysteroscopic sterilization which involves placing a small coil or some other insert into fallopian tubes through cervix. This insert will eventually cause formation of scar tissue & therefore seal off fallopian tubes.
Doctors will take the following steps when patients decide to undergo tubal ligation.
In case of women undergoing tubal ligation shortly after childbirth or during C-section, they should use contraception for at least one month prior to tubal ligation procedure & continue using to the next menstrual period so as to decrease likelihood of pregnancy. Undergoing this procedure during period or during days between period & ovulation reduce chances of pregnancy at the time of procedure. Doctors also give a sensitive pregnancy test to patients on the day of tubal ligation surgery so as to make sure that they are not pregnant.
Tubal ligation is normally done when women are recovering from vaginal childbirth of during C-section delivery. A small incision called minilaparotomy is made under the navel for this purpose. Interval tubal ligation is performed as an outpatient procedure which is separate from childbirth.
Interval tubal ligation is performed under short-acting general anesthesia with help of laparoscopic surgery, which is a thin tube equipped with camera lens & light. A needle is inserted or incision made through navel for women undergoing interval tubal ligation so that abdomen can be inflated with nitrous oxide or carbon dioxide gas, after which a laparoscope is inserted into abdomen. However, in most cases surgeons will make a second small incision so as to insert special instruments for operation. These instruments passed through the abdominal wall will help surgeons seal fallopian tubes by destroying segments or blocking them with clips or plastic rings.
For women undergoing tubal ligation following vaginal childbirth, surgeons will most likely make a small incision under navel so as to provide easy access to still enlarged uterus & fallopian tubes. For women undergoing tubal ligation during C-section, surgeons will use the same incision which was made to deliver the baby to perform the tubal ligation procedure.
Tubal ligation is basically an abdominal surgical operation usually performed under the influence of general anesthesia. Risks associated with tubal ligation procedure include the following.
Tubal ligation does not protect patients from sexually transmitted diseases. Fewer than 1 out of 100 women are found to get pregnant in the first year after tubal ligation. Chances of tubal ligation sterilization failure, is most likely to occur among women who are younger. Moreover, there is higher chance of pregnancy being ectopic – where fertilized egg implants outside uterus & usually in fallopian tubes – when women conceive after having undergone tubal ligation procedure.
Gas will be withdrawn in case abdomen was inflated with gas during interval tubal operation. Patients are usually allowed to go home several hours after completion of procedure. Even in case women have tubal ligation in combination with childbirth, it is not likely to prolong stay at the hospital.
Patients can take ibuprofen or acetaminophen for pain, but avoid taking aspirin since it increases bleeding. It is recommended to bathe 48 hours after the tubal ligation operation; however, avoid rubbing or straining the incision site for at least 7 days. Incision site should be carefully dried after bathing. Tubal ligation patients should also avoid strenuous exercise like lifting & sexual intercourse for at least 15 days following surgery. However, normal activities can be gradually resumed as they begin to feel better. In case stitches are dissolvable, they will not require any removal. Check it up with the doctor if any follow-up appointment is required. In case patients have concerns or are not healing properly, they should consult the doctor. Also make it a point to contact the healthcare provider immediately in case patients experience the following symptoms after tubal ligation surgery.
Patients who think they are pregnant at any point of time after having undergone tubal ligation should immediately contact the doctor. They should also bear in mind that even though tubal ligation reversal is possible, the involved procedure is complicated & does not guarantee to be effective.
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