Tubal ligation
You don't need to be Editor-In-Chief to add or edit content to WikiDoc. You can begin to add to or edit text on this WikiDoc page by clicking on the edit button at the top of this page. Next enter or edit the information that you would like to appear here. Once you are done editing, scroll down and click the Save page button at the bottom of the page.
| Tubal ligation
| |
| Background | |
| B.C. 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 |
| Clinic review | None |
| Advantages and Disadvantages | |
| STD protection | No |
| Benefits | Almost perfect contraception |
|
WikiDoc Resources for Tubal ligation | |
|
Articles | |
|---|---|
|
Most recent articles on Tubal ligation Most cited articles on Tubal ligation | |
|
Media | |
|
Powerpoint slides on Tubal ligation | |
|
Evidence Based Medicine | |
|
Clinical Trials | |
|
Ongoing Trials on Tubal ligation at Clinical Trials.gov Trial results on Tubal ligation Clinical Trials on Tubal ligation at Google
| |
|
Guidelines / Policies / Govt | |
|
US National Guidelines Clearinghouse on Tubal ligation NICE Guidance on Tubal ligation
| |
|
Books | |
|
News | |
|
Commentary | |
|
Definitions | |
|
Patient Resources / Community | |
|
Patient resources on Tubal ligation Discussion groups on Tubal ligation Patient Handouts on Tubal ligation Directions to Hospitals Treating Tubal ligation Risk calculators and risk factors for Tubal ligation
| |
|
Healthcare Provider Resources | |
|
Causes & Risk Factors for Tubal ligation | |
|
Continuing Medical Education (CME) | |
|
International | |
|
| |
|
Businness | |
|
Experimental / Informatics | |
Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [1] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
Tubal ligation (informally known as getting one's "tubes tied") is a permanent form of female sterilization, in which the fallopian tubes are severed and sealed or "pinched shut", in order to prevent fertilization. Hormone production, libido, and the menstrual cycle can be affected by a tubal ligation.[1]
Procedure
In women, a tubal ligation can be done in many forms; through a vaginal approach, through laparoscopy, a minilaparotomy ("minilap"), or through regular laparotomy. Also, a distinction is made between postpartum tubal ligation and interval tubal ligation, the latter not being done after a recent delivery. There are a variety of tubal ligation techniques; the most noteworthy are the Pomeroy type that was described by Ralph Pomeroy in 1930, the Falope ring that can easily be applied via laparoscopy, and tubal cauterization done usually via laparoscopy. In addition, a bilateral salpingectomy is effective as a tubal ligation procedure. A tubal ligation can be performed as a secondary procedure when a laparotomy is done; i.e. a cesarean section. Any of these procedures may be referred to as having one's "tubes tied."
Tubal ligation can be performed under either general anesthesia or local anesthesia (spinal or epidural, often supplemented witha tranquilizer to calm the patient during the procedure). The default in tubal ligations following on from cesarean birth is usually spinal/epidural, while the default in non-childbirth related situations may be general anesthesia as a matter of doctor preference. However, tubal ligations under local anesthesia, either inpatient or outpatient, may be performed under patient request.
Less commonly performed is the Essure procedure, in use since 2002. In this procedure micro-inserts are placed within the fallopian tubes by means of catheter and Hysteroscopy. The micro-inserts produce eventual occlusion of the fallopian tubes by causing the in-growth of tissue.
Reversal
Generally tubal ligation procedures are done with the intention to be permanent, and most patients are satisfied with their sterilizations. Tubal reversal is microsurgery to repair the fallopian tube after a tubal ligation procedure.
Usually there are two remaining fallopian tube segments - the proximal tubal segment that emerges from the uterus and the distal tubal segment that ends with the fimbria next to the ovary. The procedure that connects these separated parts of the fallopian tube is called tubal reversal or microsurgical tubotubal anastomosis.
In a small percentage of cases, a tubal ligation procedure leaves only the distal portion of the fallopian tube and no proximal tubal opening into the uterus. This may occur when monopolar tubal coagulation has been applied to the isthmic segment of the fallopian tube as it emerges from the uterus. In this situation, a new opening can be created through the uterine muscle and the remaining tubal segment inserted into the uterine cavity. This microsurgical procedure is called tubal implantation, tubouterine implantation, or uterotubal implantation.
Tubal reversal, if done by a specialist microsurgeon, has a high success rate and few complications. Successful repair of the fallopian tubes is now possible in 98% of women who have had a tubal ligation, regardless of the type of sterilization procedure.
IVF in vitro fertilization may overcome fertility problems in patients not suited to a tubal reversal.
Access
In developing countries, tubal ligation is generally a popular form of birth control, and is widely available, although some Muslim countries (e.g. Egypt and Indonesia) do not permit it.[1] Faith-based medical institutions in developed countries will sometimes refuse to perform tubal ligations [1], and where long waiting times persist, there is a worrying risk of pregnancy or complications due to alternative contraception.[1] Because of the permanent nature of the operation, women under 40 without children are often denied access to tubal ligation, even if they express a determined desire not to have children.[1]
References
See also
External links
Birth control | |
|---|---|
| Comparison: | Comparison of birth control methods |
| Behavioral: | Avoiding vaginal intercourse: Anal sex, Oral sex, Non-penetrative sex, Masturbation, Abstinence Including vaginal intercourse: Fertility awareness, Rhythm Method, Withdrawal, Breastfeeding infertility |
| Barrier: | Condom, Female condom, Diaphragm, Cervical cap, Lea's Shield |
| Spermicide: | Contraceptive sponge |
| Hormonal: | Combined: Combined oral contraceptive pill ('the Pill'), Contraceptive patch, NuvaRing, Combined injectable contraceptive Progestogen only: Progestogen only pill ('minipill'), Depo-Provera, Norplant/Jadelle, Implanon |
| Anti-estrogen: | Ormeloxifene (a.k.a. Centchroman) |
| Intra-uterine: | IUD (copper or progestogen), IUS (progestogen) |
| Post-intercourse: | Contraception: Emergency contraception (pills or copper IUD) Abortion: Surgical abortion, Medical abortion (RU-486/abortion pill) |
| Sterilization: | Male: Vasectomy Female: Tubal ligation, Essure |
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
