What Is Tubal Ligation?

A tubal ligation is a surgical procedure for women who want a permanent form of birth control. It is popularly referred to as “tying your tubes.” The procedure targets the fallopian tubes, which carry the eggs from the ovaries to the uterus. The tubes are cut or tied off, blocking egg and sperm cells from reaching each other. Tubal ligations are highly effective in preventing pregnancy. There are several surgical procedures for tubal ligation. These vary in degree of invasiveness. Though tubal ligation is an effective form of birth control, it is also a permanent procedure that is difficult to reverse. If you’re considering a tubal ligation, consult with a member of the women’s health team at Baptist Health.

Effectiveness of Tubal Ligation

Tubal ligation has a success rate of about 99 percent in preventing pregnancy. The rare exceptions occur primarily when the fallopian tubes aren’t fully sealed off. Keep in mind that tubal ligations are meant to be a permanent form of birth control. Reversal procedures for tubal ligations do exist for women who change their mind about pregnancy but they’re not always successful.

Types of Tubal Ligation Surgery

There are three primary procedures for tubal ligation:

• Laparoscopy: A laparoscopic procedure is the least invasive form of tubal ligation. Your surgeon will make two small incisions in your abdominal region, one for a laparoscope or slender viewing tube, and the other for a surgical instrument that will cut or tie off the fallopian tubes. Laparoscopic procedures are typically done on an outpatient basis and have relatively short recovery times.
• Laparotomy: A laparotomy is a traditional procedure in which the surgeon makes a large incision in the abdomen through which he or she can access the fallopian tubes. This is an inpatient hospital procedure followed by a relatively long recovery period at home. With the development of less-invasive laparoscopic procedures, laparotomies are being utilized in more selective ways, such as tubal ligations performed following a C-section delivery.
• Mini-laparotomy: A mini-laparotomy (or “mini-lap”) is a hybrid of the two previous approaches, combining a traditional surgical procedure with a smaller, less invasive incision. Mini-laps are frequently performed following vaginal delivery.

A related procedure, called a salpingectomy, is the surgical removal of the fallopian tubes from the body. It eliminates altogether the very small risk of pregnancy associated with tubal ligations (which includes ectopic pregnancies). It also reduces the risk of ovarian cancer, which sometimes originates in the fallopian tubes. Salpingectomies cannot be reversed.

Risks and Considerations of Tubal Ligation

Like any surgical procedure, a tubal ligation has risks.

Potential health concerns include:

• Infection
• Fever
• Abdominal bleeding or pain
• Vaginal discharge
• Rash
• Adverse reactions to anesthesia
• Organ damage
• Incomplete blockage of a fallopian tube
• Fertilization of an egg outside the uterus (an ectopic pregnancy)

Other considerations include the cost and recovery time of the surgical procedure. Recovery from a laparoscopic procedure is relatively quick; recovery from more traditional surgery usually involves a hospital stay and a recuperation period at home of several weeks. You’ll be physically limited in what you can do during that time period.

What Are the Long-term Side Effects of Tubal Ligation?

The outlook for most women undergoing tubal ligation is positive. The procedure eliminates the need for other forms of birth control. It will not end your periods. In fact, your menstrual cycle will return to a more natural pattern in the absence of hormonal methods of birth control. Keep in mind that tubal ligation prevents pregnancies but will not protect you from sexually transmitted infections.

Some women with tubal ligations develop a condition called post-tubal ligation syndrome (PTLS). PTLS has several symptoms, including cramping, headaches, pelvic or lower-back discomfort, and pain during sexual intercourse. If you experience symptoms like these in the aftermath of surgery, contact your physician.

Who Is a Good Candidate for Tubal Ligation?

Tubal ligation isn’t for everyone. Good candidates are adult women who:

• Are certain that they don’t want to be pregnant (or pregnant again)
• Are age 40 years or older with a family history of ovarian cancer
• Have other medical issues that might be complicated or worsened by a future pregnancy.

To be fully informed about the potential risks and benefits of tubal ligation, speak with your physician during the decision-making process.

Alternatives to Tubal Ligation

There are a number of alternative forms of birth control for women who want the option of pregnancy in the future. These include birth control pills, intrauterine devices (IUDs), and diaphragms, none of which permanently disable a woman’s reproductive system. A woman’s male partner can also opt for a vasectomy, which is a permanent form of birth control for men.

Tubal ligations are a proven form of birth control for women. They nearly eliminate the possibility of pregnancy following surgery. Because these procedures are difficult to reverse, women choosing a tubal ligation should consider all their options carefully. If you want to know more about tubal ligations, call a Baptist Health doctor for a consultation today!