Tubal ligation
From Wikipedia, the free encyclopedia
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Tubal ligation
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| Background | |
| B.C. type | Sterilization |
| First use | 1930 |
| Failure rates (per year) | |
| Perfect use | 0.5% |
| Typical use | 0.5% |
| Usage | |
| Duration effect | Permanent |
| Reversibility | Sometimes |
| User reminders | None |
| Clinic review | None |
| Advantages | |
| Benefits | Almost perfect contraception |
| Disadvantages | |
| STD protection | No |
| Weight gain | No |
Tubal ligation (informally known as getting one's "tubes tied") is a permanent form of female sterilization, in which the fallopian tubes are severed and sealed, in order to prevent fertilization.
In women, a tubal ligation can be done in many forms; through a vaginal approach, through laparoscopy, a minilaparotomy ("minilap"), or through regular laparotomy. Also, a distinction is made between postpartum tubal ligation and interval tubal ligation, the latter not being done after a recent delivery. There are a variety of tubal ligation techniques; the most noteworthy are the Pomeroy type that was described by Ralph Pomeroy in 1930, the Falope ring that can easily be applied via laparoscopy, and tubal cauterization done usually via laparoscopy. In addition, a bilateral salpingectomy is effective as a tubal ligation procedure. A tubal ligation can be performed as a secondary procedure when a laparotomy is done; i.e. a cesarean section. Any of these procedures may be referred to as having one's "tubes tied."
Less commonly used is the Essure procedure, developed in 2002, of occluding the fallopian tubes by the scarring effects of desposited pellets inserted by a catheter passed through the cervix and uterus.
[edit] Reversal
Generally tubal ligation procedures are done with the intention to be permanent, and most patients are satisfied with their sterilizations. Tubal ligation reversal is microsurgery to repair the fallopian tube after a tubal ligation procedure.
Usually there are two remaining fallopian tube segments - the proximal tubal segment that emerges from the uterus and the distal tubal segment that ends with the fimbria next to the ovary. The procedure that connects these separated parts of the fallopian tube is called tubal reversal or microsurgical tubotubal anastomosis.
In a small percentage of cases, a tubal ligation procedure leaves only the distal portion of the fallopian tube and no proximal tubal opening into the uterus. This may occur when monopolar tubal coagulation has been applied to the isthmic segment of the fallopian tube as it emerges from the uterus. In this situation, a new opening can be created through the uterine muscle and the remaining tubal segment inserted into the uterine cavity. This microsurgical procedure is called tubal implantation, tubouterine implantation, or uterotubal implantation.
Tubal reversal, if done by a specialist microsurgeon, has a high success rate and few complications. Successful repair of the fallopian tubes is now possible in 98% of women who have had a tubal ligation, regardless of the type of sterilization procedure. Dr. Berger of Chapel Hill Tubal Reversal Center reports two-thirds of patients become pregnant within a year of their reversal. As expected, younger women had higher pregnancy rates than older women; pregnancy rates after tubal reversal surgery ranged from 77% for women under 30 to 34% for women over 40 years of age and older. He also cautions that tubal reversal patients need to monitor their early pregnancies for slightly increased chances of ectopic pregnancy.
IVF in vitro fertilization may overcome fertility problems in patients not suited to a tubal reversal.
[edit] See also
| Birth control edit | ||
|---|---|---|
| Sterilization: | Tubal ligation, Vasectomy, Essure | |
| Post-intercourse: | Abortion: Surgical, Medical Emergency contraception |
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| Intra-uterine: | IUD, IUS (progestogen) | |
| Anti-estrogen: | Ormeloxifene (a.k.a. Centchroman) | |
| Hormonal: | Combined: COCP ('the Pill'), Patch, Nuvaring Progestogen only: POP mini-pill, Depo Provera, Norplant, Implanon |
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| Barrier: | Male condom, Female condom, Diaphragm, Shield, Cap, Sponge, Spermicide | |
| Behavioral: | Coitus interruptus, Rhythm Method, Lactational, Fertility awareness Avoiding vaginal intercourse: Anal sex, Oral sex, Outercourse, Masturbation, Abstinence |
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