Tubal Ligation and Tubal Implants
Reference Tubal ligation Opens New Window Reference Opens New Window, often referred to as "having your tubes tied," is a surgical procedure in which a woman's Reference fallopian tubes Opens New Window are blocked, tied, or cut. Reference Tubal implants Opens New Window Reference Opens New Window, such as Essure, are small metal springs that are placed in each fallopian tube in a nonsurgical procedure (no cutting is involved). Over time, scar tissue grows around each implant and permanently blocks the tubes. Either procedure stops eggs from traveling from the ovaries into the fallopian tubes, where the egg is normally fertilized by a sperm.
Tubal ligation and tubal implants are considered to be permanent methods of birth control for women. They are usually done by a Reference gynecologist Opens New Window. They may also be done by a Reference family medicine doctor Opens New Window or a Reference general surgeon Opens New Window.
Tubal ligation method
There are several different ways of closing the Reference fallopian tubes Opens New Window Reference Opens New Window, including clipping or banding them shut or cutting and stitching or burning them closed. Your surgeon will probably prefer one of these Reference tubal ligation methods Opens New Window Reference Opens New Window.
A tubal ligation can be done using a:
- A Reference laparoscopy or mini-lap. These are done by inserting a viewing instrument and surgical tools through Reference 2 small incisions (laparoscopy) Opens New Window Reference Opens New Window or Reference 1 small incision (mini-lap) Opens New Window Reference Opens New Window in the abdomen.
- Reference Postpartum tubal ligation Opens New Window Reference Opens New Window. This is usually done as a mini-laparotomy after childbirth. The fallopian tubes are higher in the abdomen right after pregnancy, so the incision is made below the belly button (navel). The procedure is often done within 24 to 36 hours after the baby is delivered.
An open tubal ligation (laparotomy) is done through a larger incision in the abdomen. It may be recommended if you need abdominal surgery for other reasons (such as a Reference cesarean section Opens New Window) or have had Reference pelvic inflammatory disease (PID) Opens New Window, Reference endometriosis Opens New Window, or previous abdominal or pelvic surgery. These conditions often cause scarring or sticking together (Reference adhesion Opens New Window) of tissue and organs in the abdomen. Scarring or adhesions can make one of the other types of tubal ligation more difficult and risky.
Laparoscopy is usually done with a Reference general anesthetic Opens New Window. Laparotomy or mini-laparotomy can be done using general anesthesia or a Reference regional anesthetic Opens New Window, also known as an epidural.
Reference Reversing a tubal ligation is possible, but it isn't highly successful. This is why tubal ligation is considered a permanent method of birth control.
Tubal implant method
Implants, such as Essure, are inserted in the fallopian tubes without surgery or general anesthesia. The procedure is done in a doctor's office, an outpatient surgery center, or a hospital, and it doesn't require an overnight stay. The implant procedure itself takes about 10 minutes.
- Before the procedure, your Reference cervix Opens New Window is first opened (dilated) to reduce the risk of injury to the cervix. Your doctor will use a Reference speculum Opens New Window and a dilating instrument to gradually open the cervix just before the procedure.
- For the procedure, you are positioned as you would be for a pelvic exam. Your doctor passes a thin tube (catheter) through your vagina and cervix, into the uterus, and then into a fallopian tube. The catheter is used to place an implant into a fallopian tube. An implant is then placed in the other fallopian tube the same way. You may have some menstrual-like cramps afterwards.
After the procedure, an Reference X-ray Opens New Window is taken to make sure the implants are in place and the tubes are closed.
In some cases, a tubal implant can be difficult to insert. Should this happen, a second procedure is needed to completely block both tubes.
For the first 3 months after insertion, you must use another method of birth control. At 3 months, dye is injected into your uterus and an X-ray is taken (Reference hysterosalpingography Opens New Window) to make sure that the implants are in place and the tubes are fully blocked by scar tissue. If they are, you will no longer have to use another method of birth control.
|By:||Reference Healthwise Staff||Last Revised: August 14, 2012|
|Medical Review:||Reference Sarah Marshall, MD - Family Medicine
Reference Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology