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Tubal ligation

Tubal ligation is a procedure in which the Fallopian tube, which allows the sperm to fertilize the ovum and would carry the fertilized ovum to the uterus, is closed.

The closing of either type of tube can be done in several different ways, some of which are more permanent or guaranteed to work than others. The tube can be

• Clamped off
• Cut off
• Tied off
• Blocked

Types of tubal ligation

• Mini-laparotomy
• Laparoscopy
• Laparotomy
• Culpotomy
• Culdoscopy
• Hysteroscopy
• Hysterectomy

Each procedure carries different risks and benefits. Be sure the clinic discusses surgical options with you, describes the risks, and answers all of your questions before the surgery. Mini-laparotomies and laparoscopies are the two most common techniques for female sterilization.

Procedure

Depending on the technique used the procedure  can be performed as an out-patient surgery done in a clinic, doctor's office, or hospital. It can be performed under local or general anesthesia.

In the laparoscopy procedure, the surgeon makes a small cut just below the navel and inserts his laparoscope. A second incision is made just above the pubic hairline to allow the entrance of the instrument that will cut, sew or burn the tubes. The surgery takes about half an hour.

Although pregnancy is unlikely, there is a slightly higher risk of ectopic pregnancy after a tubal ligation. An ectopic pregnancy occurs when a fertilized egg attaches and grows outside the uterus. This can be very dangerous and requires immediate medical attention.

Abnormal bleeding and bladder infections are risks after tubal ligations.

Some women report having post-tubal sterilization syndrome. They report irregular and painful periods, mid-cycle bleeding, no periods, lack of interest in sex and other negative changes after the tubal ligation. While some physicians believe there is no evidence that this syndrome exists, others believe more research should be done.

Women who have reversal surgery and become pregnant have a higher chance of ectopic pregnancy. Surgery to reverse a tubal ligation is not always effective. In addition, reversals are both difficult and expensive.

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