Couple/Sexuality

Tubal ligation

What is tubal ligation? Is it reversible? What is the procedure and what are the consequences of tying the tubes? Here are some points to consider before making this important decision.

Tubal ligation is a surgical procedure to prevent pregnancy permanently. Although it is sometimes possible to reverse its effects with a second surgery, it is a procedure for women who do not want children.

Decision-making

As mentioned above, tubal ligation is a surgical procedure that is intended to prevent pregnancy permanently and it involves a number of risks. That is why it is so important to be sure that you do not want any more children before considering it. Several doctors also suggest waiting a few months after giving birth before making this decision. If you have any doubt, it would be safer to use another contraception method because the surgery that reverses tubal ligation is not always successful.

Advantages and disadvantages

Tubal ligation does not interfere with the hormonal cycle, causes no side effects, is reliable, permanent and will cut the expenses related to contraception for good. However, it requires several appointments with your doctor, which also means a long waiting period. Also, its permanent nature might bring regrets if the mother changes her mind along the way.

Procedure and risks

Tubal ligation can be performed during a C-section while the patient is already under anaesthesia if her decision was already made. Otherwise, the surgery will be performed under general or local anaesthesia as a laparoscopy, which means that the doctor will insert a camera and a light below the navel and the other tools in an incision above the pubis. To prevent the passage of eggs into the uterus, fallopian tubes can be blocked using rings or burned with electricity before being tied up. This procedure lasts about 30 minutes and the patient can go home on the same day.

Among the risks associated with the surgery, neighbouring organs such as the ovaries, bowel and uterus could be damaged during surgery. Bleeding and infection can also occur and blood vessels and nerves could be damaged. If complications occur, emergency surgeries or blood transfusions could be required. Although very rare, deaths have also been reported.

Following surgery

The surgery is effective immediately and contraception is no longer needed when leaving the hospital, except if you have more than one partner since it does not protect against sexually transmitted infections. Women who underwent tubal ligation still have menstrual periods and can resume sexual activity as soon as it is comfortable to do so or between four and seven days after surgery.

Convalescence lasts two to five days during which women may experience cramps, neck and shoulder pain, mild nausea and a dry throat if a breathing tube was used during surgery. It is also possible to suffer from general fatigue and to notice a swollen abdomen.

Accidental pregnancy

Following surgery, a small risk of pregnancy ranging from 1% to 2.5% remains. In general it is the youngest patients who are most at risk of unintended pregnancy. If you become pregnant after tubal ligation, you are likely to have a normal pregnancy but the risk of ectopic pregnancy is increased. If you have undergone this surgery and you feel a sharp pain on one or both sides of your lower abdomen, if you skipped menstruation and if you feel weak or dizzy, you should consult a doctor promptly.

Image de Anne Costisella

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