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Dr Komalas Women Clinic - Tubectomy

In recent years, family planning strategies are gaining immense popularity. A woman can opt for the sterilization procedure if she decides to limit the number of kids she bears.

WHAT IS TUBECTOMY?

Tubectomy or Tubal ligation is tying or ligating the fallopian tubes that connect the ovaries to the uterus. It is an irreversible process, i.e., a woman cannot get pregnant post-surgery. Tubectomy can be performed along with the C-section, combining two surgical procedures to avoid more incisions, anesthesia, and financial burden later. The surgical procedure is an effective form of a birth control strategy that prevents the movement of eggs from the ovaries to the womb. However, the surgery does not affect the menstruation cycle or sexual activity. 

WHY CHOOSE TUBECTOMY?

  • Doctors proceed with tubectomy only when a patient consents to the surgery. 
  • A woman must be sure of not wanting children in the future. 
  • If a woman has a history of ovarian cancer in her family, she can choose to undergo a tubectomy.
  • If the pregnancy leads to the offspring inheriting defective genes or genetic diseases, a woman can decide against getting pregnant.
  • If a woman decides to have a baby after a tubectomy, the reversal procedure enables her to have a baby in rare cases. Such women can choose In-vitro fertilization (IVF) instead of tubal ligation.

WHAT ARE THE RISKS INVOLVED?

Every surgery brings risks or complications. Similarly, tubectomy comes with its risks. They are:

  • Damage to major blood vessels in the abdomen
  • Cross-reaction to anesthesia or antibiotics
  • Prolonged pelvic or abdominal pain
  • Hemorrhage
  • Infection
  • Surgical procedure failure may lead to unwanted ectopic pregnancy.

Alternative complications may occur in the following situations:

  • If you are obese
  • If you have diabetes
  • If you have undergone other abdomen or pelvic surgery before, which might result in pelvic inflammatory diseases.
  • If you have blood disorders such as blood pressure issues, infection, low hemoglobin, etc. 

PRESURGICAL CARE

  • Inform the doctor of previous medication. 
  • Quit smoking and drinking (if applicable) 
  • Eat healthy food. However, avoid eating anything eight to ten hours before surgery.
  • Take medically prescribed medicines (if any) before the surgery. 

TUBECTOMY PROCEDURE

  • Before the procedure, the doctor will inject intravenous lines with anesthesia that will put you to sleep. 
  • The surgical procedure will roughly take 30 to 45 minutes if no other complications arise. 
  • The surgical area will be sterilized. 
  • Small incisions made in the belly button region and the abdomen give a better view of the organs. 
  • The surgeon locates the fallopian tubes and introduces a cut to clamp them. 
  • The doctor cuts and ties the fallopian tubes with the help of clips, rings, or electric current. 
  • Once the ligation is complete, the surgeon sutures the abdominal incisions with absorbable stitches.

POSTOPERATIVE CARE AND RECOVERY PERIOD

  • The patient can go home after a few hours post-surgery once the anesthesia wears off.
  • Recovery takes almost a week. 
  • You may observe discomfort for a few days followed by:
    • Nausea or dizziness
    • Bloating
    • Abdominal or pelvic discomfort and pain
  • Avoid physical stress such as heavy exercise and sex. 
  • Regularly check your sutures for leakage, redness, and swelling.
  • The nurses may keep an eye on the sutures for tearing and infection.  

In rare cases, women may observe some of the following:

  • High fever, which may be an indication of infection
  • Fainting
  • Heightened abdominal pain
  • Bleeding from the surgical wound

PROS AND CONS OF TUBECTOMY
Some pros of tubectomy are:

  • Tubectomy is a permanent solution if you do not wish to have more children. 
  • Less than 1% of women get pregnant after tubectomy. 
  • Tubectomy blocks the meeting of sperm and ovum in the fallopian tube. It does not affect your body’s sex hormones, libido, or menstrual cycle. 
  • You do not have to worry about ovulation, pregnancy, condoms, pills, etc. 
  • Tubectomy does not cause any side effects, unlike birth control pills. Pills cause mood swings, heavy menstrual bleeding, cramps, and weight gain.  
  • After tubectomy, the chances of ovarian cancer decrease in most women. 
  • Your sex life will not be affected. Usually, women can have intercourse after eight to ten days of tubal ligation. 

The cons of tubectomy are:

  • It is permanent. If you decide to have kids in the future, IVF is a better option than tubectomy. 
  • Undergoing tubectomy does not protect your partner from Sexually Transmitted Diseases (STDs). 
  • The rare cases of pregnancy after tubectomy may lead to an ectopic pregnancy, where the fertilized egg implants outside the uterus and not within. 
  • At any given time, if you are pregnant, seek medical knowledge and expert advice. The ectopic pregnancy fetus does not usually survive the pregnancy and requires surgery. 

Some women may experience Post-tubal Ligation Syndrome (PTLS) with symptoms such as hot flashes, mood swings, vaginal drying, disturbed sleep patterns, heavy menstrual flow, etc.

If the symptoms mentioned above persist for a long time after a tubectomy, you must seek immediate medical attention. Do not self-medicate at any cost. 

Tubectomy can cost around 75,000 INR to 4,50,000 INR. Both birth givers have to consent to tubectomy since it is permanent. 

Alternative Family Planning Strategies

  1. Apart from tubectomy, there are other alternatives for birth control and family planning. Like tubectomy for women, men can also undergo a surgical procedure called vasectomy. The surgical procedure blocks the sperm’s entry into the semen. 
  2. Another method is using Intrauterine devices (IUDs). They are placed in the uterus and can be 99% effective in birth control. IUDs can remain in the uterus for three to ten years. 
  3. Gynecologists may also recommend an implant under the skin that releases the hormone progestin to prevent pregnancy. It is effective under the skin for up to three years. 

Yes. To avoid contracting STDs, you must use a condom. Tubectomy does not prevent STDs.

Absolutely. The surgical procedure does not negatively affect sex hormones, periods, and sex life.

There is less than a 1% chance of pregnancy after the surgery. However, if you still get pregnant, you will need immediate medical attention as you may have an ectopic pregnancy.

Performing tubectomy soon after C-section is best to avoid multiple surgeries in the future, but this is possible only with the patient’s consent. The surgery may also take place within three to four days after a natural delivery. If a woman wishes to not have kids in the future, she can undergo surgery within a week after her menstruation cycle.

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Komala’s Women Clinic is a multidisciplinary organization dedicated to the advancement of the art, science and practice of reproductive medicine.

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Doctor Komala’s Women Clinic Newtown Medical Centre First Floor, Major Sandeep Unnikrishnan Rd, Yelahanka New Town, Bengaluru, Karnataka 560064

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