Tubal ligation

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What you can expect

By Mayo Clinic staff

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Illustration of tubal ligation 
Tubal ligation

Tubal ligation is usually done with a laparoscope — a thin tube equipped with a camera lens and light — under short-acting general or regional anesthesia. It can be done while you're recovering from vaginal childbirth (minilaparotomy) or during a C-section delivery. It can also be done as an outpatient procedure (interval tubal ligation) separate from childbirth.

During the procedure
If you have a tubal ligation as an outpatient procedure, a needle is inserted through your navel and your abdomen is inflated with gas (carbon dioxide or nitrous oxide). Then a small incision is made, and the laparoscope is inserted into your abdomen. In some cases, your doctor may make a second small incision to insert special grasping forceps. Using instruments passed through the abdominal wall, your doctor seals the fallopian tubes by destroying segments of the tubes or blocking them with plastic rings or clips.

If you have a tubal ligation after vaginal childbirth, your doctor will likely make a small incision under your navel, providing easy access to your still enlarged uterus and fallopian tubes. If you have a tubal ligation during a C-section, your health care provider will use the incision that was made to deliver the baby.

After the procedure
If your abdomen was inflated with gas during the procedure, the gas will be withdrawn. You may be allowed to go home several hours after the procedure. If you have the procedure in combination with childbirth, the tubal ligation isn't likely to prolong your hospital stay.

Whether or not you have the tubal ligation in combination with childbirth, you'll need to rest for at least a day after the procedure. You will have some discomfort at the incision site. You might also experience:

  • Abdominal pain or cramping
  • Fatigue
  • Dizziness
  • Gassiness or bloating
  • Shoulder pain
  • Sore throat

You may take acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) for pain relief, but avoid using aspirin, since it may promote bleeding. You may bathe 48 hours after the procedure, but avoid straining or rubbing the incision for one week. Carefully dry the incision after bathing.

Avoid strenuous lifting and sex for one week. Resume your normal activities gradually as you begin to feel better. Your stitches will dissolve and won't require removal. Make an appointment to see your health care provider a week after the procedure to make sure you're healing properly.

Contact your health care provider immediately if you experience:

  • A temperature of 101 F (38.3 C) or greater
  • Fainting spells
  • Severe abdominal pain that's persistent or gets worse after 12 hours
  • Bleeding from your incision that's persistent or gets worse after 12 hours, despite use of pressure and bandages
  • Discharge from your incision that's persistent or gets worse

If you think you're pregnant at any time after the tubal ligation, contact your health care provider immediately.

Keep in mind that although tubal ligation reversal is possible, the procedure is complicated and not guaranteed to be effective.

References
  1. Zieman M. Overview of contraception. http://www.uptodate.com/home/index.html. Accessed Sept. 23, 2011.
  2. Frequently asked questions: Birth control methods. U.S. Department of Health and Human Services. http://www.womenshealth.gov/publications/our-publications/fact-sheet/birth-control-methods.pdf. Accessed Sept. 23, 2011.
  3. Kottke M. Nondaily contraceptive options: User benefits, potential for high continuation and counseling issues. Obstetrical & Gynecological Survey. 2008;63:661.
  4. Stovall TG, et al. Surgical sterilization of women. http://www.uptodate.com/home/index.html. Accessed Sept. 23, 2011.
  5. Pollack AE, et al. Female and male sterilization. In: Hatcher RA, et al. Contraceptive Technology. 19th ed. New York, N.Y.: Ardent Media, Inc.; 2007:363.
  6. Kulier R, et al. Minilaparotomy and endoscopic techniques for tubal sterilization. Cochrane Database of Systematic Reviews. 2004:CD001328.
  7. Cunningham FG, et al. Williams Obstetrics. 22nd ed. New York, N.Y.: McGraw-Hill Companies, Inc.; 2005:1.
  8. Stubblefield PG, et al. Family planning. In: Berek JS. Berek & Novak's Gynecology. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2007:287.
  9. FAQs: Sterilization for women and men. American College of Obstetricians and Gynecologists. http://www.acog.org/publications/faq/faq011.cfm.  Accessed Sept. 23, 2011.
MY01000 Dec. 2, 2011

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