Tubal ligation, also known as having one's tubes tied, is intended as a permanent birth control that blocks sperm from reaching the fallopian tubes to meet an egg. Tubal ligation is often done as an outpatient surgery which means that you will go home the same day. Surgery can also be done at the hospital right after you have given birth or you can return at a later date to have the procedure done. Once you have decided that it is a good idea to get your tubes tied, you will want to discuss the various methods of having your tubes tied with your doctor.
Methods for Having Your Tubes Tied
There are several ways the surgeon can perform this tied tube procedure. Permanent birth control methods you may consider include:
Pomeroy Tubal Ligation
The Pomeroy method is a very common method of tubal ligation. The doctor takes a loop of the fallopian tube and ties it off with a piece of suture. The loop is then cut off above the tie; the ends of the cut tubes are sometimes burned as well. Eventually the two sections will heal separated from each other. This procedure can be performed laproscropically, through the vagina, or through an incision in the abdomen. It is frequently performed after giving birth.
The Pomeroy is very effective; however, it is also possible to have a successful reversal after this type of tubal ligation. Success rates depends on the amount of tube that is removed; if more than 3.5 cm were removed, the remaining tube may be too short.
Spring Clips and Bands/Rings
Two types of clips can be used for tubal ligation. The first is a small clamp, which shuts over a fallopian tube with a spring. The second is a rounded one that clamps down on the tube to keep it closed. Both the clips and rings lead to fibrosis and scarring in the tube which effectively creates a blockage and prevents the egg from traveling through. Bands are usually placed over a looped fold in the tube; the looped portion scars and the two healthy ends separate.
Your physician can perform this procedure laporoscopically and -- depending on the type of clip -- after you give birth. Tubal ligations using clips, bands, or rings can often be reversed with possible pregnancy rates after reversal between 65 and 76%.
Bipolar Coagulation
Bipolar coagulation is a common form of tubal ligation as well. The doctor grasps the fallopian tube with forceps and an electrical current traveling through the forceps damages the tube. The actual area that is damaged is small so the physician usually performs the procedure at several different sites on the tube.
This procedure can be performed laporoscopically so it is not typically done right after giving birth. The amount of tube that is ultimately destroyed impacts the possibility of reversal; if a large amount of the tube was damaged, it may present challenges with reversal and future pregnancies.
Parkland Tubal Ligation
This procedure involves tying two sutures around the fallopian tube and cutting out the portion in between the sutures. It is often viewed as a modification of the Pomeroy Technique and can be performed after a c-section, vaginal birth, or laporoscopically.
It is often possible to reverse this type of procedure as well depending on the amount of fallopian tube that was removed originally. If a large amount of the tube was removed, it may be more difficult to reconnect the cut ends of the tubes and have the tube work successfully. Up to two thirds of women get pregnant after a reversal.
Irving and Uchida Tubal Ligations
In the Irving and Uchida methods, the doctor removes a portion of the tube and then tucks the remaining part back into the surface of the uterus or the area above the ovary. This type of ligation typically can be done after giving birth as well.
An additional goal of these procedures -- besides prevention of birth control -- is to reduce the risk of an opening growing between the two cut parts; this is the main cause of birth control failures in tubal ligations. However, these procedures can be successfully reversed but again it depends on the amount of tissue that was removed during the initial procedure.
Inserts: A New Alternative
Several alternative methods for tubal ligation have appeared on the marketplace in the last few years. Sold under the brand name Essure, this method eliminates the surgical procedure while giving a woman the same sterilization benefits as having tubes tied. There was another form called Adiana; however, Adiana is no longer produced and sold to doctors. If your doctor still has some of the product, it is possible he or she may still use it.
Both products are small inserts placed into fallopian tubes. Scar tissue then forms around the inserts, effectively blocking the sperm from reaching an egg. Instead of requiring surgery for implantation, the tubes are accessed through the vagina. Effectiveness of Essure is comparable to surgical tubal ligation procedures.
The methods listed above are more involved than the simplified explanation given. For more detailed information, speak with your primary care physician.
An Important and Possibly Lifelong Decision
For women who are done having children or do not want any at all, using one of the methods of having your tubes tied listed above can provide a hassle-free permanent birth control. However, you need to be positive that you do not want children or do not want any more children. While you can attempt a tubal reversal, it is not a guarantee of pregnancy.
Weighing the Pros and Cons
The method you choose for having your tubes tied will have direct bearing on how successful a possible tubal reversal could be in the future. If there is any possibility you would change your mind, a clip or band is often the easiest type of tubal sterilization methods to reverse. Women who change their minds and want to have children may find they need in vitro fertilization to conceive. Be sure to weigh the pros and cons of each type of tubal ligation and discuss potential side effects of getting your tubes tied with your healthcare practitioner.
