TUBAL LIGATION

DEFINITION

is a permanent voluntary form of birth control (contraception) in which a woman's fallopian tubes are surgically cut or blocked off to prevent pregnancy.

HISTORY

In 1880 in Toledo, OH, Lungren was first to ligate a woman's tubes

• In the 1960s, the era of laparoscopy began with unipolar electrocoagulation of the fallopian tube. Failure rates and safety concerns associated with both unipolar and bipolar electrosurgery led to the development of laparoscopic devices that do not require radiofrequency energy.

• In 1973, Jaroslav Hulka devised a spring clip that could be applied laparoscopically.2

• In 1981, Filshie introduced a titanium and silicone clip that was widely used in Europe. It was not introduced into the United States until the 1990s.3

• In 2002, the Essure hysteroscopic sterilization procedure was approved for use in the United States.

PURPOSE

is performed in women who want to prevent future pregnancies

DESCRIPTION

Tubal ligation, or getting one's "tubes tied," refers to female sterilization, the surgery that ends a woman's ability to conceive. The operation is performed on the patient's fallopian tubes. These tubes, which are about 4 in (10 cm) long and 0.2 in (0.5 cm) in diameter, are found on the upper outer sides of the uterus.

• They open into the uterus through small channels. It is within the fallopian tube that fertilization, the joining of the egg and the sperm, takes place. During tubal ligation, the tubes are cut or blocked in order to close off the sperm's access to the egg. Normally, tubal ligation takes about 20–30 minutes, and is performed under general anesthesia, spinal anesthesia,

METHODS

• Laparoscopic Tubal Ligation • Minilaparotomy• Hysteroscopy• Microlaparoscopy• Electrocoagulation

ADVANTAGES

• is a permanent method of birth control offering immediate

• highly effective protection against unexpected pregnancy

• can enjoy more spontaneous sex life

DISADVANTAGES

• does not offer any protection against sexually transmitted diseases (STD’s)

• some women may have regrets for what they have done

RISKS/COMPLICATIONS

• involve infection and uterine perforation

• to experience abnormal bleeding and bladder infections after surgery

• have post-tubal ligation syndrome, which involves irregular and painful periods, bleeding in a mid-cycle, or no menstrual periods

IMPACT

At some point in their lives many women decide to pa surgical procedure known as tubal ligation, more commonly called “getting your tubes tied”. Later in their life, they may decide that they wish to children but are fearful that their tubal ligation procedure was permanent.

Many reasons may lead a woman had previously tied her tubes to regret her decision. Young age at time of tubal ligation, the higher factors to regret;

• The younger woman is at the time of tubal ligation, the higher the chance that at some point she will desire to be pregnant again. Furthermore, some women are pressured by their partners to have their tubes tied, due to various financial or personal issues. In addition, some women may lose their significant other or divorce and subsequently remarry, wishing to have children with their new partner