Tubal ligation
| Tubal ligation / Tubectomy/ BTL surgery | |
|---|---|
| Background | |
| Type | Sterilization |
| First use | 1930 |
| Failure rates (first year) | |
| Perfect use | 0.5% |
| Typical use | 0.5% |
| Usage | |
| Duration effect | Permanent |
| Reversibility | Sometimes |
| User reminders | None |
| Advantages and disadvantages | |
| STI protection | No |
| Risks | Operative and postoperative complications |
Tubal ligation or tubectomy (also known as having one's "tubes tied") is a surgical procedure for sterilization in which a woman's fallopian tubes are clamped and blocked or severed and sealed, either of which prevents eggs from reaching the uterus for implantation. Tubal ligation is considered a permanent method of sterilization and birth control.
Tubal ligation (incorrectly referred to as tubectomy) is considered major surgery, typically requiring the patient to undergo local, general, or spinal anesthesia. It is advised that women should not undergo this surgery if they currently have or had a history of bladder cancer. After the anesthesia takes effect, a surgeon will make a small incision at each side of, but just below the navel in order to gain access to each of the two fallopian tubes. With traditional tubal ligation, the surgeon severs the tubes, and then ties (ligates) them off thereby preventing the travel of eggs to the uterus. Other methods include using clips or rings to clamp them shut, or severing and cauterizing them. Tubal ligation is usually done in a hospital operating-room setting.
A tubal ligation is approximately 99% effective in the first year following the procedure. In the following years the effectiveness may be reduced slightly since the fallopian tubes can, in some cases, reform or reconnect which can cause unintended pregnancy. Method failure is difficult to detect, except by subsequent pregnancy, unlike with vasectomy or IUD.
Of those failures, 15–20% are likely to be ectopic pregnancies. 84% of those failures occurred a year or more after sterilization. According to one study, approximately 5% of women who have had tubal ligation will have a failure due to ectopic pregnancy. Time seems to be a factor as the risk of failure increases after 1 or more years post-surgery. The risk of ectopic pregnancy is 12.5% for women who have had tubal ligation, which is a greater risk than for those who have not had the surgery. Recanalization or formation of tuboperitoneal fistulas occur, the openings of which are large enough for passage of sperm but too small to allow an ovum to push through, resulting in fertilization/implantation in the distal tubal segment.
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