After having a child or a couple of children, many parents take the wise decision of undergoing sterilisation. This is permanent contraceptive method that helps in prevention of pregnancy. Women no longer have to worry about morning after pills or have problems making their partners wear condoms. Partners too, no longer have to worry about accidentally impregnating their wives. Once a woman who has given birth to children and no longer wishes to get pregnant, she can think of undergoing female sterilisation. This is a permanent solution to prevent unwanted pregnancies and will last for life. The process to carry out female sterilisation is called tubal ligation or tubectomy. Informally referred to as ‘getting your tubes tied’, it is done to block the fallopian tubes and prevent fertilisation. As a part of the reproduction process, the egg produced in the ovary travels to the uterus. Either way, the sperm enters the fallopian tubes for fertilising the egg. After conducting a tubal ligation procedure, entry of the egg or sperm to the fallopian tube is denied, thus, preventing fertilisation. Apart from a few side effects observed post this surgery, it is a relatively safe procedure.
What is Tubal ligation or tubectomy?
A surgical procedure that helps in blocking the fallopian tubes and thus preventing pregnancy is called tubal ligation or tubectomy. When the sperms are deposited in the vagina, they travel up to the uterus and reach the fallopian tube. It is here, where the sperms meet the egg released from the ovary in the fimbrial end of the fallopian tube. If the fallopian tubes are blocked, it does not allow the sperms to meet the ovaries. Thus, fertilisation does not take place and pregnancy is prevented. So, when one undergoes tubal ligation, it literally means, the fallopian tubes have undergone ‘ligature’ or ‘tying’. Thus, many times tubal ligation is referred to as ‘tying’ the tubes.
The fallopian tubes are actually narrow muscular organs that arise from the uterus. These tubes end just next to the ovary and are internally lined by cilia (microscopic hair-like projections). These tubes are about 10 cm in length and divided into several segments. The first segment passes through the uterine muscles and is called interstitial segment. The narrow muscular segment by the uterus is called the isthmic segment. The middle segment that is wider than other segments is called the ampullary segment. The end that is shaped like a funnel near the ovary is called the infundibular segment. And lastly, the ciliary lining that faces the ovary is called the fimbrial segment.
How a tubal ligation or tubectomy procedure is performed?
You will undergo a complete medical examination, including the required diagnostic tests. By studying the data obtained from observation and testing, the doctor will review the potential risks and benefits of tubal ligation in your case. He will also look at other options, and thereby advise you about the best possible one for you. If this sterilisation procedure is expected to be safe and secure in your case, he will move ahead and give you a date for the surgery.
In the operation theatre, the doctor will prepare your body for the surgery.
- He will administer a general anaesthetic to put you to sleep. He may also use local freezing.
- When the anaesthetic agent has produced its effect, the doctor will place a speculum into your vagina.
- He will place a small instrument at the end of your cervix. This instrument helps the doctor move the uterus in different positions easily. The doctor needs to move the uterus to get a clear picture of the pelvic structures as seen through a laparoscope.
- The doctor makes a cut at a point just below the navel. He inserts a trocar through this cut into your abdomen. A trocar is a tube which the doctor uses to fill your abdomen with carbon dioxide gas. Again, the purpose is to get a clear picture of the pelvic structure.
- He will now insert a laparoscope to see the inside of your abdomen on a video screen. The doctor blocks the tubes with clips or bands, or will cauterise with the help of electric current.
- Sometimes, the need may arise to make a larger incision in the lower abdomen to block the tubes with clips, burning or cutting, and tying.
- Tubal ligation being an outpatient procedure, you will most likely be discharged on the same day.
Side Effects of a tubal ligation or tubectomy procedure
The procedure of tubectomy in favour of family planning is controversial, which is mainly because of the probable after-effects of the procedure. While some go through a painful tubal ligation syndrome, others may not experience any such discomfort symptoms at all. Also, this surgical procedure is not effective for protection against sexually transmitted diseases (STD) such as AIDS. Some of the negative effects of tubectomy are as follows:
- Tubal Ligation Syndrome: One of the most commonly reported bilateral tubal ligation side effects is tubal ligation syndrome. As the term signifies, it encompasses various symptoms including a painful menstrual cycle, excess menstrual bleeding, an irregular menstrual cycle, and missing periods.
- Infection: As a surgery (minimal invasive or regular) is involved in tubectomy, there are chances of infection at the operating site. Internal injuries are another risk it poses. Some women even report of bladder infection and uterine perforation after the procedure.
- Birth Control: As per statistics, the success rate of birth control with tubectomy is approximately 99.5%. So, even after the procedure, there is still a 0.5% risk of getting pregnant. And, the concerning issue is that a pregnancy after tubectomy is mostly ectopic, i.e., the fertilised egg implants and develops outside the uterus.
- Excess Bleeding: With any type of surgery, it is usual to experience some bleeding. However, a woman undergoing tubectomy suffers a high risk of abnormal bleeding during and after the procedure. Those suffering from blood clotting disorders are at a higher risk of experiencing this side effect than others.
- Other Side Effects: Weight gain is observed in some recipients. A few of them experience mood swings and sexual health problems after the surgery. Most of these side effects occur due to the sudden change in the hormonal levels (which normalise over time).
Tubal Ligation Recovery
After gaining consciousness, you may feel mild abdominal pain and cramps, dizziness, nausea, shoulder pain, and tiredness. You may also experience bloating and general fatigue. The general anaesthesia may cause throat soreness. You should not drive or perform strenuous physical activity for the next 24 hours. All these symptoms, if apparent, will last for 5-6 days. You will return to your usual routine, and start leading a normal life within a week or so after the procedure.
Recovery time of tubal ligation depends on a number of factors. They include your ability to tolerate pain, the type of anaesthesia used, and your body’s natural ability to heal. As the wound at the site of the surgery heals, you may find it to be sore. You may get tired in the evening, and notice minor changes in your bowel movements. The abdominal pain and discomfort usually go away with pain killers. You will continue your menstrual cycle. The tubal ligation surgery does not alter your menstrual cycle.
If you think that your family is complete, and you do not want to get pregnant anymore, you can consider going for tubal ligation or tubectomy. In addition to giving you a permanent result, it is a safe and effective surgery. It does not affect your menstrual cycle, and is also believed to lower the risk of ovarian cancer.