Some women are in search of a more permanent form of contraception. Tubal ligation and salpingectomy are 2 options available. Here we answer all your questions on these 2 procedures.
What is the difference?
Tubal Ligation is a procedure that bands, clamps, cauterizes or blocks the fallopian tubes to prevent an egg from traveling from the ovary to the uterus as well as prevent sperm from traveling from the uterus towards to ovaries.
Salpingectomy is the complete removal of 1 (unilateral) or both (bilateral) fallopian tubes.
How are these procedures done?
Both are done through keyhole laparoscopic surgery as a day patient or can be completed at the same time as a c-section. An incision is made in your belly button to feed a laparoscope into your abdomen. This piece of equipment has a light and camera on it allowing the surgeon to see inside your abdominal cavity. Gas will be pumped into the abdominal cavity and the surgeon will make a few other incisions on the abdomen to feed in other tools. These tools are used to band, clamp, cauterize or block fallopian tubes or to completely remove them.
Risks of these procedures
- internal bleeding or bleeding at the surgical site
- damage to blood vessels
- damage to other internal organs
- allergy to anaesthesia
- improper wound healing
What signs do I need to seek urgent medical assistance after this surgery?
- fever 38C (100.4F)
- severe abdominal pain
- bleeding from wound that soaks through bandage
-discharge from wound that is fowl smelling
- redness or swelling around the incisions
- heavy vaginal bleeding
- inability to empty bladder
What is the recovery like for these procedures?
Laparoscopic surgery is relatively non-invasive. Expect to wake from surgery groggy and sore with the possibility of nausea. Fatigue, dizziness, bloating and shoulder pain is all completely normal. Expect to pass more gas than you normally would following the procedure as the gas that was used to expand your abdomen works its way out.
If you had outpatient surgery, you will not be released until you can stand up and have emptied your bladder.
Follow your doctor’s recommendations for resuming normal activities. It may take only a few days, but it is possible it could be longer. Avoid heavy lifting or strenuous exercise for at least a week.
What are their fail rates?
Tubal Ligation: The fail rate is less than 1%. These statistics do show that the younger you are when having this procedure, the higher risk you are for it to fail.
Salpingectomy: The fail rate is less than 0.3%.
Both statistics are incredibly low, but please be aware that it is still a possibility and protective measures should still be taken.
How do these procedures effect my cycle?
Your cycle should continue as normal. If you have been on contraception prior to the procedure it is generally recommended to continue it for a month following the surgery. Some women report cramping to be more painful and bleeding to be heavier after this surgery however there has not been extensive research to confirm these findings.
What happens if I change my mind after having one of these procedures?
A tubal ligation is possible to reverse, but it is not guaranteed. Reversal is also expensive as it is considered a luxury surgery and not a necessary surgery. If the reversal procedure is a success there may be other factors hindering conception including scar tissue, age, hormone levels, etc.
A salpingectomy is not reversible. You are not able to put back something that was completely removed.
In both procedures the likelihood of requiring IVF procedures to conceive in the future is high. Your doctor will have a lengthy discussion with you about the possibility of changing your mind before agreeing to complete the surgery.
Am I protected against STD's?
No. You still need to use a barrier contraception like condoms or female condoms to protect against any sexually transmitted infections or diseases. If you suspect you have an STI or STD, please contact your medical provider urgently for testing and treatment.