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Tubal Ligation

Currently, the only approved method of permanent sterilization involves tying, ligating or removing the fallopian tubes. This procedure prevents the sperm and egg from meeting in the fallopian tube for fertilization to occur. Interrupting this process has no effect on your menstrual cycle. A tubal procedure can be done when you are ready for permanent sterilization and the type of procedure should be discussed with your provider as there may be secondary benefits aside from permanent sterilization.

Risks of Tubal Surgery

Although tubal surgery is considered a minimally invasive surgery, it does require general anesthesia and incisions in the abdomen. The likelihood of complication is small, but there are risks with any surgery. 

Risks include:

  • Damage to the bowel, bladder, or major blood vessels
  • Reaction to anesthesia
  • Improper wound healing or infection
  • Failure of the procedure (although much less likely with complete tubal removal)
  • If failure occurs, there is an increased risk of ectopic pregnancy

The risks of surgery increase if you are overweight, have diabetes, or have had prior abdominal or pelvic surgery. Be sure to discuss the procedure thoroughly with your provider before making your final choice.

Preparing for Bilateral Tubal Ligation: What to Expect

In the months leading up to the procedure, it is best to use birth control to ensure you do not become pregnant. Before the surgery, you will be asked to take a pregnancy test as final confirmation. Your provider will also review the following items:

  • The risks and benefits of both reversible and permanent contraception
  • Details of the procedure
  • Causes of sterilization failure
  • Preventing sexually transmitted infections
  • The best times to perform the surgery

Timing of Tubal Surgery

Tubal surgeries can be performed at the time of delivery as well as a separate procedure.  If you give birth by C-section, no additional incisions are required.  It is also possible to perform tubal surgery following a vaginal delivery (although this is much less common). In order to minimize anesthesia risk, tubal surgery is performed under epidural anesthesia.  This will require a small incision made under the navel, followed by elevation of the fallopian tube into the incision.  It is important that you consider this option prior to delivery so that you have had time to consider the risks and benefits of surgery.  

Tubal surgeries performed separately from delivery are outpatient procedures.  A small incision is made near the navel to introduce a camera to allow visualization of the pelvic organs. To facilitate this, the abdomen is inflated with carbon dioxide, and one or two additional incisions are made lower on the abdomen to allow insertion of the instruments used to grasp the fallopian tube.  Following this, the fallopian tube is ligated, cauterized, or removed based on a discussion made prior to the surgery with your physician.  Following the procedure, all the instruments are removed and the incisions are sealed with suture or glue.

Tubal Surgery Recovery

There are a few things to expect after the tubal ligation procedure is complete. You might experience:

  • Pain at the incision site
  • Abdominal discomfort
  • Fatigue
  • Dizziness (from the anesthesia)
  • Bloating or abdominal fullness
  • Shoulder pain

Although some patients may return to work the following day, some do require a day or two of rest prior to returning to work.  Additional precautions may also include limiting strenuous physical activity, avoiding submersion of incisions, and refraining from sexual intercourse for a few days.  Before you leave the hospital, be sure to discuss with your provider post-procedure precautions and pain management. 

Do not hesitate to call your doctor if you have any concerns about not healing properly. Call your doctor right away if you experience:

  • Fever of 100.4 F or higher
  • Severe abdominal pain
  • Unusual nausea, vomiting, or dizziness
  • Bleeding through the bandage
  • Foul-smelling discharge from the wound

These may be signs of complications from internal bleeding, infection, or damage to adjacent organs and should be dealt with immediately. 

Schedule a Consultation with Capital Women’s Care

To learn more about tubal surgeries and to schedule a consultation, contact your local Capital Women’s Care Center today.