Women who are looking for a permanent form of birth control may choose to have a tubal ligation, also known as getting your “tubes tied” or female sterilization. This surgical procedure to make a woman sterile is very effective at preventing pregnancy, with a failure rate as low as 0.4%.

What Is It?

A tubal ligation is a surgical procedure whereby a woman’s fallopian tubes are cut, clamped, blocked or tied to prevent her eggs from traveling down to her uterus. It also blocks the sperm from traveling along the tube to meet the egg. In some cases, a woman may choose to have a hysterectomy. This is when the entire uterus (and possibly the fallopian tubes, ovaries and/or cervix) is removed. Unlike a tubal ligation, a hysterectomy is not reversible.

While a tubal ligation is generally regarded as a permanent type of birth control, tubal ligation reversal surgery is available. However, depending on how your tubal ligation affected your fallopian tubes, you may not be a candidate for reversal surgery. Even if you do have your tubal ligation reversed, you may still not be able to get pregnant. Success rates for pregnancy after a tubal ligation reversal range between 70% and 80%. Additionally, there is an increased risk of experiencing an ectopic pregnancy.

Tubal ligation is a relatively simple out-patient surgery done in a clinic, doctor’s office, or hospital. It can be performed under local or general anesthesia. Mini-laparotomies and laparoscopies are the two most common techniques for female sterilization. Other procedures include laparotomy, culpotomy, culdoscopy, hysteroscopy, and hysterectomy. Each procedure carries different risks and benefits. Be sure the clinic discusses surgical options with you, describes the risks, and answers all of your questions before the surgery.

In the laparoscopy procedure, the abdomen is filled with carbon dioxide gas so that the abdominal wall balloons away from the uterus and tubes. The surgeon makes a small cut just below the navel and inserts a laparoscope, a small telescope-like instrument. A second incision is made just above the pubic hairline to allow the entrance of the instrument that will cut, sew or burn the tubes. The surgery takes about half an hour.

There may be up to several months delay between your request for surgery and the day it is performed. You may want to consider other birth control methods in the meantime. Young women with no children may have difficulty finding a surgeon to perform the procedure.

After surgery, it is recommended that women take 2 to 3 days off and only perform light activities for a week. Sexual activity can start again when a woman feels comfortable, usually after a week. Women who have surgery performed through their vagina are advised not to put anything into their vagina for 2 weeks to avoid infection.

Risks of Tubal Ligation

As with any type of surgery, there are risks involved with having your tubes tied, including infection and uterine perforation. Additionally, women who have had their tubes tied and become pregnant are more likely to experience an ectopic pregnancy. Other possible risks associated with having your tubes tied include menstrual cycle disturbances and gynecological problems.

While a tubal ligation is an effective way of preventing pregnancy, it offers absolutely no protection against sexually transmitted diseases). Therefore, it will still be necessary to use condoms unless you are in a relationship with someone that has tested negative for STDs.

Advantages

  • Permanent birth control.
  • Immediately effective.
  • Allows sexual spontaneity.
  • Requires no daily attention.
  • Not messy.
  • Cost-effective in the long run.

Disadvantages

  • Does not protect against sexually transmitted infections, including HIV/AIDS.
  • Requires surgery.
  • Has risks associated with surgery.
  • More complicated than male sterilization.
  • May not be reversible.
  • Possible regret.
  • Possibililty of Post Tubal Ligation Syndrome.

Will this surgery affect my libido?

No. The procedure has no effect on your sex drive or your hormone production. You’ll still ovulate each month, only the egg will never reach your uterus (it’s reabsorbed by your body). You’ll also continue to have menstrual periods.

Tubal Ligation Vs. Vasectomy

Many times when couples decide they don’t want more children, or that children are not a part of their future, they decide that one of them will undergo permanent surgical sterilization. Permanent sterilization is the most effective method of contraception. Although tubal ligation and vasectomy can sometimes be reversed, both procedures should be considered a permanent end to your ability to have children.

One of the first things to decide is which partner will undergo permanent sterilization. Women have the option of having a tubal ligation, while men may choose to have a vasectomy performed.

The most common method of permanent sterilization is tubal ligation. However, this may be due to the fact that many couples don’t realize that vasectomy involves far less risk to men than the risks associated with tubal ligation for women.

In fact, vasectomy is usually performed in the physician’s office rather than the hospital setting required for tubal ligation.

How do you decide who will undergo surgical sterilization? Educate yourselves about both the tubal ligation and vasectomy procedures. Learn what happens during each procedure. Find out about recovery from both methods of permanent sterilization. Ask about possible complications and / or any long-term consequences associated with either tubal ligation and vasectomy. Is one procedure more effective than the other? Once you’re armed with the answers to these questions then you and your partner can make an educated decision that leaves both of you feeling comfortable with your choice.

Tubal Ligation or Vasectomy?

  • Vasectomy is a 30 minute procedure performed in the physician’s office. Tubal ligation is performed in a hospital setting, most often on a day surgery unit.
  • Vasectomy requires two small incisions in the scrotum performed under local anesthetic; tubal ligation involves a small abdominal incision usually performed under general anesthesia. Occasionally, surgeons will perform tubal ligation under local anesthetic, however, this option is rarely instituted.
  • Vasectomy involves the cutting of the tubes (vas deferens) that carry sperm. The vas deferens are then sealed using either sutures or surgical clips on the end of each of the tubes. On the other hand, tubal ligation permanently ends the possibility of pregnancy by one of several methods; these methods typically involve cutting the fallopian tubes and then sealing them or clipping them so that sperm and egg cannot meet. You may have heard people say they had their “tubes tied,” however, actually tying fallopian tubes is an antiquated method of tubal ligation that is no longer done by today’s gynecologists.
  • Recovery from vasectomy usually requires only that the patient refrain from heavy physical activity for approximately 48 hours; tubal ligation requires women to limit physical activity and heavy lifting for at least one week following surgery.
  • Complications from vasectomy are relatively rare but can involve bleeding and infection, swelling of the scrotum, as well as the possibility of sperm granulomas (small, inflamed hard nodules at the end of the severed tube)–these usually heal on their own, however in some cases additional surgery may be required. Potential complications from tubal ligation include a slight risk of bleeding and infection.
  • The failure rate for vasectomy is about 1 percent. The failure rate for tubal ligation is slightly higher at about 2 percent which translates into a risk of pregnancy occurring following tubal ligation of about 1 pregnancy in 1000 women who’ve undergone this procedure.

Sources: Epigee, Birth Control

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