Tubal ligation: my experience and everything you need to know about the process

The truth is that I had never considered having a tubal ligation due to the doubt whether or not it was reversible . Also, as I am quite clueless about medication issues, I have never taken the contraceptive pill because I was convinced that out of 10 times I would forget nine. That’s how I am.

When I had my first child, I decided to look for a contraceptive method of a certain duration and I opted for the IUD, despite the numerous testimonies that “I have an acquaintance who got pregnant with it.” My experience was not very positive, but I will leave it for another post. When I found out that I was going to have twins, I knew that I would not have any more children and that was when my gynecologist asked me if in case of cesarean section I would want to undergo a tubal ligation. Great question, never thought about it! I had quite a few doubts, on the one hand I didn’t raise more children, but what if one day I cheered up again? Was it reversible?

Before undergoing the operation, I decided to collect as much information as possible and not from any source but from my trusted gynecologist whom I thoroughly interviewed in order to make a decision with certainty. I was especially interested in knowing how long the process lasted, possible side effects, if it was reversible … Then you can see all my doubts cleared.

How is the process done?

It can be done in two ways:

  • Laparotomy tubal ligation: it is the most common during a cesarean section since the abdomen is opened where it is used to cut a piece of each tube and tie them. Recovery will basically depend on the opening in the abdomen, in this case the cesarean section.
  • Laparoscopic tubal ligation: through a small 10 mm incision. a small television camera is inserted into the navel. So on the monitor you can see the abdominal cavity inside and see the tubes and ovaries. The abdomen is inflated with gas (CO2) and by distending everything can be appreciated without problem. In this case the tubes are removed not tied.
  • Essure method: until now it was another of the usual procedures but since August 3, 2017, the Spanish Agency for Medicines and Health Products has suspended the use of this method in Spanish hospitals . Patients have reportedEffects such as pelvic inflammatory disease, severe pain in the pelvic and abdominal region, or tubal perforation. Other symptoms that have occurred have been cramps, bleeding and nausea, changes in the menstrual cycle or a possible allergic reaction due to the materials of the implants, such as nickel. In some cases, contraception has even failed. But how was it done? It did not require a surgical incision or anesthesia, but it was a titanium metallic micro-insert that was inserted inside the tube producing an inflammation that eventually became a scar. This scar was the one that acted as a barrier and obstructed the tube, preventing pregnancy. For this method to work, at least 3 months had to pass from its placement.

How long does the procedure take?

If it is done during a cesarean section, it takes about 10 min. more or less, depending on how accessible the tubes are. If it is performed in a non-pregnant patient, the intervention is performed laparoscopically, that is, without having to open the gut through trocars through the umbilicus, insufflating gas to distend the abdomen and have a field of vision. This procedure is quick, it is done with sedation and it takes about 20-30 minutes; the patient can go home the same day. What is done is to remove the tubes, not to tie them, as when intra-caesarean section is done.

In my case it was during a cesarean section and the truth is that the ligation and closure of my scar was quite fast and very soon I was in a room alone with my babies and my husband recovering without problem.

Are there any side effects?

Whether a tubal ligation is done or removed (salpingectomy) there are no side effects, since the tubes only have the job of transporting the oocyte to the uterus. The only effect it has is contraception.

Personally, I have not noticed anything different in my menstruation or anything similar.

As indicated by the WHO, “in general, female sterilization practiced using the techniques described (…) is risk-free, so complications arise in rare cases.” But they cite some specific points such as:

  • Side effects are those symptoms attributable to the surgical intervention but that do not require exceptional measures. These include abdominal, back or chest pain, nausea and vomiting.
  • Complications are problems directly related to surgery or anesthesia that occur over the next 42 days and require more far-reaching measures and treatments than might be expected. These include infection, hemorrhage, accidental injury, and depression of breathing or blood pressure caused by anesthesia.

What are the advantages and disadvantages?

In case our goal is not to have more children, the advantage is that, contraceptive. It does not have any disadvantages or side effects. It does not affect the cycle or the rules of the woman.

Is it reversible?

No. The reversal of the operation has very few possibilities and the solution that would achieve a successful pregnancy would be to resort to IVF. That is why it is important to be very clear about this decision.

This part was what scared me. It was giving up being a mother again. I already have three children but I didn’t know if I wanted to repeat the experience and that scared me …

At this point, the WHO points out that “female sterilization should not be proposed or used as a reversible method of fertility regulation. Although reconstructive surgery operations can be used to restore fertility and several countries have created services for this purpose, the The proportion of clients who request these services and then become pregnant is very low. ” So … think about it.

Do you know of any cases where the process has failed?

According to my gynecologist, during her entire professional career she has only seen one case of a woman who with a tubal ligation became pregnant.

When I signed the consent I already said it, it is not 100% effective as it happens with the rest of contraceptive methods.

In addition, he told me that tubal ligation is usually offered when the patient is going to undergo a second or third cesarean section and it is absolutely clear that her genetic wishes have been fulfilled.

Anesthesia, the main handicap

Generally, the reason that patients change their minds and finally do not decide to undergo this procedure has to do with the fear of sedation, which is with local anesthesia. Specifically, salpingectomy is a safe technique and the laparoscopic approach only leaves a very small scar, so the fear of anesthesia is not a reason to decide whether or not to do it. Despite everything, there is still a lot of fear of anesthesia in our environment.

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