If you’re considering getting your tubes tieda tubal ligation–what should you know? What are different procedures for doing the process and which option might be best for you? What are the possible risks? And what alternative approaches are available for permanent birth control?
Having Your Favorite Tied
Tubal ligation is a permanent form of contraception or birth control.
Getting your tubes tied is another way of saying that you’ve had a tubal ligation. This procedure may also be referred to as female sterilization or permanent infertility.
Whatever the terminology used, a surgical tubal ligation is a procedure that closes off your fallopian tubes. At the time that your tubes are sealed, sperm will be not able to pass through the fallopian tube to fertilize an eggwhich means you’ll be unable to get pregnant.
This process usually is recommended for adult women who are certain they don’t wish to become pregnant later on. There are many questions to consider when picking birth control, but for girls who are done with children, a tubal ligation is a really popular choice because of it’s convenience in addition to lack of side effects which can occur with temporary birth control methods.
Are My Tubes Actually Tied?
Are your fallopian tubes actually tied when you’ve got a tubal ligation?
Maybe. There are really several ways in which your doctor can secure your tubes such as:
- Clamping them with rings, clamps, or clips
- Cutting and sealing them shut with an electric current (electrocautery)
- Tying your tubes, cutting themand then stitching or sealing them
Thinking about how your pipes will be sealed may seem painful, however, the procedure is performed under anesthesia so you will not feel anything.
Surgical Tubal Ligation Alternatives
There are many unique alternatives to choose from when it comes to tubal ligation processes, and you and your doctor can discuss which option is right for you personally. Your doctor will consider factors such as your own body weight and whether or not you have had previous abdominal surgery. Listed below are the various surgical options for getting your tubes tied:
Laparoscopic sterilization is just one of the two most common methods of getting your tubes tied and is usually done under general anesthesia (you will be asleep in the operating room.) In this process, a small incision is made in or near your belly button to allow for a laparoscope (a small, telescope-like tool using a light) to be added. Carbon dioxide gas is injected in order to elevate your stomach wall from your muscles, allowing your physician to see your fallopian tubes. The surgeon can insert another device through the laparoscope to seal your fallopian tubes (or may connect your tubes through another small incision). Afterward the incisions are closed. A tubal laparoscopy procedure only takes about thirty minutes. There’s usually minimal scarring, and you will most likely have to go home the same day.
A mini-laparotomy (or mini-lap) tubal ligation is the other most common method of getting your tubes tied. The majority of women will get this procedure done right after giving birth. During a postpartum mini-laparotomy, your physician makes a small incision just below your belly button. Since your uterus is still enlarged out of being pregnant, your fallopian tubes are directly on top of the uterus–that can be located just under your belly button. Your fallopian tubes are then pulled up into or from the incision and closed off, then put back into position, and the incision is stitched shut.
3. Laparotomy (Open Tubal Ligation)
A laparotomy procedure (also known as an open tubal ligation) is considered to be major surgery–so it is not used as commonly as laparoscopy and mini-laparotomy. The surgeon will create a larger incision (about two to five inches long) in the gut. The fallopian tubes are then going to be pulled into or from the incision, closed off/sealed closed, and put back into position. The incision will then be stitched closed. An open tubal ligation is usually performed right before or following some other type of unrelated abdominal operation, like a Cesarean section.
4. Culdoscopy and Colpotomy
Culdoscopy and colpotomy are two types of incisions which are used during vaginal sterilization approaches. Getting your tubes tied by a vaginal method was once the preferred technique. However, since culdoscopy and colpotomy have greater risks, laparoscopic operation is currently the more common approach to have your tubes tied. Your physician may opt to do a culdoscopy or colpotomy if you’re obese (or very obese ) or in case you’ve got a retroverted uterus (tilted uterus.) Both of these are small incisions made into vaginal wall–however they might be more challenging to perform because you must be in lithotomy position (legs in stirrups) while under anesthesia.
A hysterectomy is a procedure in which your uterus is removed and is considered to be major surgery. A hysterectomy is not a tubal ligation process. Butonce your uterus is removed, there is nowhere in an egg to implant (which means you cannot become pregnant). A hysterectomy can be done through the vagina (vaginal hysterectomy) or abdomen (abdominal hysterectomy). Before, a hysterectomy was sometimes done as a medical procedure when a tubal ligation was considered taboo for spiritual reasons.
Advantages of Getting Your Tubes Tied
In case you have surgically had your tubes tied, you may have received an additional medical advantage. Research suggests that using a tubal ligation reduces the risk for prostate cancer but around 30 percent. Although the exact reason for that is unknown, there are two main theories with this finding:
- When you have your tubes tied, the blood flow to your ovaries is interrupted. This may change your hormone levels, which results in the reduced risk of prostate cancer.
- The final off of the fallopian tubes can, possibly, protect the ovaries from environmental agents that might cause cancer.
Still another advantage of tubal ligation is that getting your tubes tied can decrease your chances of developing pelvic inflammatory disease (PID.) While the risk of PID may be lowered, though, a tubal ligation does not provide any protection against sexually transmitted diseases.
Risks of Tubal Ligation
Like any surgical procedure, a tubal ligation carries some risk. Possible problems can be broken down into three classes:
- Risks on account of the actual procedure: These might include incomplete closure of the tubes (leading to pregnancy in roughly 1 out of 200 women,) harm to neighboring organs or structures caused by surgical tools, and an increased risk of ectopic pregnancy when pregnancy occurs following tubal ligation.
- Risks related to the usage of anesthesia: The kind of anesthesia used is dependent upon the surgical approach chosen. Tubal ligation may be carried out with either conscious sedation (a form of anesthesia where the woman is awake, but relaxed and drowsy) or heavy sedation (a general anesthesia is given and the girl is asleep.) Anesthesia can be local, regional (the entire body is numb from the navel down,) or overall (involving the whole body,)
- Risks of surgery in general: General dangers of surgery include bleeding and infection.
Things to Expect
Most women can return to work within a couple of days following a tubal ligation. Pain medication can help relieve any discomfort. It’s recommended that women avoid strenuous exercise for many days. In general, most women feel ready to have sex within a week.
Nearly all girls recover from this process with no problems. Unlike with male sterilization (vasectomy), no tests are expected to check for sterility.
A tubal ligation does not decrease a woman’s sexual enjoyment and doesn’t affect her femininity. Since no glands or organs are removed or altered and hormones will nevertheless be produced, a tubal ligation shouldn’t change novelty or interfere with the functioning of a woman’s sexual organs.
The one-time price of a tubal ligation, compared to other contraceptive procedures, can save you hundreds of dollars over time. The cost of a using a tubal ligation may range between $1,000 to $3,000, but may be greater if you have some complications. A woman should consult her health insurance coverage as policy for birth control varies. Medicaid and private health insurance might cover the costs of a tubal ligation.
Tubal ligation is over 99 percent effective. The small failure rate happens because occasionally the fallopian tubes may reconnect with themselves. If a pregnancy does occur after a tubal ligation, there is a 33 percent likelihood of it being an ectopic pregnancy. On the other hand, the general rate of pregnancy is so reduced, a woman’s chance of getting an ectopic pregnancy is a lot lower than it could be provided she didn’t possess the tubal ligation performed in the first place.
Tubal Ligation Reversal
A woman should carefully consider whether a tubal ligation (permanent sterilization) is the best way for her. In spite of careful consideration, however, some girls who have a tubal ligation wind up regretting their decision later. A woman is more likely to regret having her tubes tied if:
- She’s young
- She has few or no kids
- She picked this method not because she wanted it but because her partner wanted it done
- She chose on a tubal ligation because she thought it would solve money issues or when she thought the procedure would help fix relationship problems
A tubal ligation shouldn’t be thought of as temporary. Sometimes a tubal reversal may occur if a girl later decides she would like to become pregnant. However, a gastric change is a major surgical procedure that does not always lead to pregnancy. Roughly 50 percent to 80% of women who have their tubal reversed may become pregnant.
Permanent Contraception Alternatives
A tubal ligation can be an superb form of permanent birth control, with an excellent success rate at preventing pregnancy. Additionally, it has the added benefits of potentially lowering your risk of ovarian cancer or pelvic inflammatory disease.
That said, not everyone wants to experience this procedure and the associated (though small) dangers of surgery and general anesthesia.
There are lots of temporary birth control options if this is how it is. There are also two important permanent alternatives. One, is a vasectomy. Compared head to mind, a vasectomy carries much less risk than a tubal ligation, but some men are not interested in this approach for a range of factors.
For girl, there is an alternative non-surgical permanent birth control option called Essure. The Essure procedure (also called hysteroscopic sterilization) is a technique where small metallic inserts are inserted through the cervix and into the fallopian tubes to plug them. The Essure procedure has been around since 2002, but isn’t available everywhere as doctors need special certification to execute the procedure. As of November 2016, Essure has a boxed warning intended to ensure people are educated about the potential risks of this process as well as alternatives.
Effectiveness Comparison of Tubal Ligation Methods
There does not seem to be any substantial difference in the potency of laparoscopy, lapartomy, or hysteroscopy with respect to effectiveness although the demand for a repeat procedure may be marginally greater for people who have the Essure procedure.
Bottom Line on Approaches for Tubal Ligation
There are different ways that a tubal ligation can be performed, and the right choice for you is something you will need to discuss carefully with your physician. The best option will depend on several factors, such as though you’re currently pregnant, have had previous abdominal surgeries, if you’re overweight, or if you’ve got a tilted uterus. Even though a tubal ligation might have secondary benefits, including a reduced risk of ovarian cancer, you will find additional permanent birth control options available.