Tubal Ligation

Tubal litigation is a surgical procedure performed with the objective of preventing the development of a pregnancy, rendering it a method of contraception for all intents and purposes. It is usually a planned procedure, performed when the woman or couple decides that they do not wish to have any more children.

The fallopian tubes (of which there are two) connect the ovaries to the uterus. It is in the fallopian tubes that the mature egg meets the sperm cell, and where fertilization begins. After it is initially fertilized, the egg continues on into the uterus, which is where the embryo actually develops.

This description shows how important the function of the fallopian tubes is. If they do not function properly, the egg will not meet the sperm cell, it will not be fertilized and no pregnancy will develop. Therefore, occluding the fallopian tubes – ‘tying’ them (tubal litigation) – ensures at a very high percentage rate (approximately 99%) that the woman will no longer be able to become pregnant.

It should be noted that in spite of the procedure’s high success rate, in certain cases it is possible to become pregnant after tubal litigation – whether because the procedure was not performed properly, or by having it ‘reversed’ (which can be done only in certain cases, and only if specific methods were employed for tubal litigation) or by means of in vitro fertilization, which enables the egg fertilization process to take place outside the woman’s body, in laboratory conditions.

General information about tubal litigation

Tubal ligation is a very effective procedure, achieving almost 100% success. Even though there were past cases in which a woman became pregnant after tubal litigation, this is quite rare. There are currently a number of methods of tubal litigation, but the operation is generally performed by the laparoscopic method (via tiny incisions in the lower abdomen) or by means of hysteroscopy – a minimally invasive operation performed via the vagina.

It should be noted that many physicians recommend performing tubal litigation in the framework of another medical gynecological procedure, such as delivery, Caesarian section and the like. Since this is not a very complex procedure, it can be performed on the same occasion, thus sparing the need for a separate operation, especially for tubal litigation.

Preparing for the procedure

Tubal ligation is almost always performed under general anesthesia, and it is, therefore, necessary to fast for several hours before the beginning of the procedure. In the days preceding the operation, you will certainly undergo some imaging examinations to assess the condition of the fallopian tubes in advance.

The course of the tubal ligation procedure

Tubal Ligation is today performed by a minimally invasive procedure, usually laparoscopy or hysteroscopy, which naturally significantly shortens the recuperation time, and is expected to make recovery much easier. Only in special cases will the operation be performed in the framework of an open operation.

There are currently a number of methods for performing tubal litigation – some reversible and some irreversible. Physically tying using a special thread, electric cautery, removal of part of the fallopian tube and deployment of a ring that causes degeneration of the fallopian tube are procedures that will almost always be irreversible. On the other hand, the use of a special clip or blocking the fallopian tube in a physical procedure that resembles scarring (fibrosis) are reversible procedures after which it is usually possible to become pregnant.

It is important to note that even when the procedure is apparently irreversible, it is possible to restore and open the tied fallopian tube – but this surgical procedure is considered to be very complex and prolonged. An additional option, which of course does not require an addition operation of the fallopian tubes, is of course “bypassing” the function of the fallopian tube and becoming pregnant by means of in vitro fertilization.

Tubal ligation is a procedure that usually takes up to one hour. It is currently performed in day hospitalization, i.e. you will probably be released to your home the same day. In the first two weeks after the procedure, it is recommended not to lift heavyweights.

Side Effects

The most common side effects after tubal litigation are period-like pain and vaginal bleeding – which are quite common effects in all gynecological procedures of this type. Bleeding and infection could also occur, as well as damage to adjacent organs, mainly organs of the lower digestive tract. These are cases that can be treated already while the procedure is being performed. A rare side effect is the failure of the litigation and becoming pregnant, which occurs in one in 1,000 cases, according to statistical data and the medical history of this procedure.