Tubal ligation
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Definition
Tubal ligation (or "tying the tubes") is surgery to close a woman's fallopian tubes. These tubes connect the ovaries to the uterus. A woman who has this surgery can no longer get pregnant (sterile).
Alternative Names
Sterilization surgery - female; Tubal sterilization; Tube tying; Tying the tubes; Hysteroscopic tubal occlusion procedure
Description
Tubal ligation is done in a hospital or outpatient clinic.
The procedure takes about 30 minutes.
- Your surgeon will make one or two small surgical cuts in your belly, usually around the belly button. Gas may be pumped into your belly to expand it. This helps your surgeon see your uterus and fallopian tubes.
- Your surgeon will insert a a narrow tube with a tiny camera on the end (laparoscope) into your belly. Instruments to block off your tubes will be inserted through the laparoscope or through a separate, very small cut.
- The tubes are either burned shut (cauterized) or clamped off with a small clip or ring (band).
Tubal ligation can also be done right after you have a baby through a small cut in the navel or during a cesarean section.
Another sterilization method involves going through the cervix and placing coils or plugs in the tubes where they connect with the uterus (hysteroscopic tubal occlusion procedure). This technique does not involve cuts in the abdomen.
Why the Procedure Is Performed
Tubal ligation may be recommended for adult women who know for sure they do not want to get pregnant in the future.
Even though many women choose to have tubal ligation, some are sorry later that they did. The younger the woman is, the more likely she will regret having her tubes tied as she gets older.
Tubal ligation is considered a permanent form of birth control. It is NOT recommended as a short-term method or one that can be reversed. Even so, major surgery can sometimes reverse it. About 50 to 80 women out of 100 who have their tubal ligation reversed are able to become pregnant. A hysteroscopic tubal occlusion procedure is very hard to reverse.
References
Mishell DR Jr. Family planning: contraception, sterilization, and pregnancy termination. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 14.
American College of Obstetricians and Gynecologists. Sterilization by laparoscopy. ACOG Education Pamphlet AP035. February 2003. Accessed January 7, 2011.
Review Date: 2/28/2011
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Sterilization surgery - female; Tubal sterilization; Tube tying; Tying the tubes; Hysteroscopic tubal occlusion procedure
After the Procedure
You will probably go home the same day you have the procedure. Some women may need to stay in the hospital overnight.
You will have some tenderness and pain. Your doctor will give you a prescription for pain medicine or tell you what over-the-counter pain medicine you can take.
After laparoscopy, many women will have shoulder pain for a few days. This is caused by the gas used in the abdomen to help the surgeon see better during the procedure. You can relieve the gas by lying down.
You should avoid heavy lifting for 3 weeks, but you can return to most normal activities within a few days.
If you have the hysteroscopic tubal occlusion procedure, you will need to keep using a birth control method until you have a test 3 months after the procedure to make sure it worked.
Outlook (Prognosis)
Most women will have no problems. Tubal ligation is an effective form of birth control for women. You will NOT need to have any tests to make sure you cannot get pregnant in the future if the procedure is done with laparoscopy or after delivering a baby.
If you have the type of sterilization done through the uterus (Essure or Adiana), you will need to have a test called hysterosalpingogram 3 months after the procedure to make sure your tubes are blocked.
Your menstrual cycles will return to whatever pattern is normal for you. If you used hormonal birth control, or the Mirena IUD before, then your periods will change to whatever is normal for you after you stop using these methods.
Women who have a tubal ligation have a decreased risk of later developing ovarian cancer.
References
Mishell DR Jr. Family planning: contraception, sterilization, and pregnancy termination. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 14.
American College of Obstetricians and Gynecologists. Sterilization by laparoscopy. ACOG Education Pamphlet AP035. February 2003. Accessed January 7, 2011.
Review Date: 2/28/2011
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Sterilization surgery - female; Tubal sterilization; Tube tying; Tying the tubes; Hysteroscopic tubal occlusion procedure
Risks
Risks for any surgery are:
- Bleeding
- Damage to other organs (bowel or urinary systems) needing more surgery for repair
- Infection
Risks for any anesthesia are:
Risks for tubal ligation are:
- Incomplete closing of the tubes, which could make pregnancy still possible. About 1 out of 200 women who have had tubal ligation get pregnant later.
- Increased risk of a tubal (ectopic) pregnancy if pregnancy occurs after a tubal ligation
- Injury to nearby organs or tissues from surgical instruments
References
Mishell DR Jr. Family planning: contraception, sterilization, and pregnancy termination. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 14.
American College of Obstetricians and Gynecologists. Sterilization by laparoscopy. ACOG Education Pamphlet AP035. February 2003. Accessed January 7, 2011.
Review Date: 2/28/2011
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 2/28/2011
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.