How to tie your tubes so you don't get pregnant. Tubal ligation as surgical contraception for women

Bandaging is one of the types of protection against fallopian tubes. This method of sterilization is performed with the help of surgical intervention and, if properly implemented, forever eliminates the possibility of becoming pregnant. The chance of an egg being fertilized and transferred to the uterus through blocked tubes is 0.6% out of 100 possible.

Conditions for a tubal ligation operation

An effective method of irreversible contraception - tubal ligation - is recommended in several cases:

If it is impossible for a woman to carry out pregnancy safely for health;
With contraindications,;
With the voluntary refusal to have children.

If a woman is over 35, she has children or contraindications to childbirth, it is necessary to give written consent to tubal ligation. How this procedure is done should be clarified with the attending physician, choosing the appropriate sterilization technique for the case.

Tubal ligation surgery consists of blocking, cutting, clamping, or implanting two fallopian tubes to create an artificial blockage. As a result of such actions, scars form in the tubes, which prevents the advancement of a mature egg from the ovaries to the uterus. This measure eliminates the possibility of the meeting of sperm and female cells and the onset of pregnancy.

How tubal ligation is done

Tubal ligation is carried out in several ways - bandaging and circumcision, tying or stapling, circumcision and electrocoagulation (cauterization).

Surgery is performed under general anesthesia and differs in the types of techniques:

Laparotomy, laparoscopy - abdominal method (surgery of the abdominal cavity);
Colpotomy - vaginal method;
Endoscopy of the uterus with the imposition of plastic microtampons.

Laparotomy with dissection of the tissues of the abdomen is performed in parallel with other surgical interventions, for example, during a caesarean section. Open tubal ligation, the consequences of which are in the nature of cosmetic defects - scars on the skin in the lower abdomen, is considered a serious abdominal operation and requires a stay in the hospital for up to 7 days.

Laparoscopy is also performed under general anesthesia, but excludes abdominal surgery. 2 incisions are made in the abdomen, through which an instrument is inserted into the abdominal cavity - a laparoscope, an examination chamber, clamps. Ligation is done with clips or clamps with cauterization of the sealed ends of the tubes. The operation lasts 30-45 minutes. The consequences of ligation of the fallopian tubes in this way are two scars in the navel and suprapubic zone of about 5 cm, soreness after recovery from anesthesia, hospitalization for about 1 week.

A colpotomy is an operation performed through the vagina. The doctor enters the abdominal cavity through the back wall of the vagina and, using a laparoscope, clamps the tubes. After such an intervention, there is no external scarring, but there is a risk of infection. You should refrain from sexual relations for 1.5 months after the operation.

With endoscopy, all manipulations to clamp the fallopian tubes occur in the umbilical zone. Through an incision in the navel, the doctor blocks the patency of the pipes with plastic caps and cauterizes the gaps.

Consequences of tubal ligation in women

Immediately after the operation for ligation of the fallopian tubes, according to the reviews of women who underwent the procedure, pain, temporary weakness, dizziness, bloating, cramps, and nausea are felt. These are side effects of the body's reaction to surgery, anesthesia.

With improper tubal ligation in women, side effects may appear in the near future:

Ectopic pregnancy;
Pregnancy - 6 cases out of 1000;
bleeding;
Development of sepsis;
Rupture of blood vessels;
inflammatory processes.

So that after tubal ligation in women the consequences are not deplorable, the procedure should be carefully planned, carried out in a stationary clinic and follow the doctor's recommendations for the rehabilitation period.

Side effects when ligating the fallopian tubes occur with poor performance, and in general, the procedure is an effective means of contraception. When deciding on sterilization, it is worth knowing that the procedure is irreversible in 99% of cases, and if life circumstances change, a woman will not be able to become a mother in a natural way again.

Tubal ligation, reviews of which are only positive, does not affect or accelerate menopause: all processes of the urogenital area, except for the function of fertilization, remain unchanged in a woman.

The search for an effective method of contraception is a topical issue for most modern women. Blocking is considered the most effective technique among the variety of methods. fallopian tubes. The option is radical and irreversible, popularly referred to as "sterilization". The procedure requires sound medical grounds, it is carried out with the written and legally certified consent of the patient. Tubal ligation often occurs with caesarean section, so the consequences for the patient's body are minimized, because there is no need for another separate surgical intervention.

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Description of the procedure

Often, surgical sterilization is used for medical reasons, much less often - as an option for contraception in a completely healthy lady. It provides for ligation, blocking or cutting of a tubular organ that plays the role of a transport channel for the female germ cell. As a result of such manipulations, the oocyte loses the ability to reach the uterine cavity, and the access of the male seed to it is blocked - which is why the probability of fertilization is excluded. Tubal ligation after cesarean is extremely medically convenient and more effective than a similar, non-postpartum procedure:

the patient is already under general anesthesia;
no additional incisions in the abdominal wall are required;
after labor, the uterus is high, due to this, good visibility is observed, and access to the paired tubular organ is completely open.

According to the results of tubal ligation, which took place after caesarean section, negative consequences are unlikely if the manipulations were carried out within 48 hours after labor.

The advantages of the technique include:

Almost zero probability of egg fertilization in the future.
No effect of surgery on health and libido.
Preservation of the hormonal background (the ovaries work correctly, hormones are produced according to age-related nuances) and the characteristics of the patient's menstruation.

The main disadvantage is irreversible infertility. In addition, in the absence of proper qualifications from the surgeon, a violation of the technique of the procedure, standard postoperative pathologies are possible - bleeding, the development of various kinds of inflammation.

Indications for dressing

According to the law, the procedure is performed only for females who have reached the age of 35 and have at least one child. Also, without fail, dressing is offered after the second, and especially the third, caesarean section. In the absence of the above conditions, surgical sterilization is allowed only for medical reasons. Basically, when the conception and further bearing of the baby is fraught with death, and the use of certain contraceptives is contraindicated for the patient.

Other indications for bandaging:

the presence of a representative of the weaker sex severe genetic diseases capable of being transmitted to the fetus;
private medical pathologies - heart defects, diabetes in severe form, malignant tumors, leukemia, uterine rupture, etc.;
serious mental disorders of the patient, calling into question the possibility of her viability as a mother.

Important! The blockage of the fallopian tubes during cesarean and the very procedure for the birth of a child are two independent, unrelated surgical processes. If, upon opening the uterus and removing the baby, it turns out that the patient can no longer become a mother without health risks, sterilization is not possible without the prior written permission of the woman in labor.

This surgical operation is allowed when the lady consciously decides not to have children anymore and is clearly aware of the radical nature of such a step. But the absence of pathologies in her that prevent dressing is mandatory even in this case.

Main contraindications

In addition, tubal ligation during cesarean, as well as sterilization at any other time, is not recommended for patients:

under 30 years old;
lonely, without stable sexual relations;
experienced a difficult pregnancy, difficult childbirth.

The procedure is excluded when a woman is ready to go for it under pressure from family members or, desperate to find effective contraceptive protection for herself. Tubal ligation is a serious, radical and irreversible operation, doctors strongly recommend resorting to it, carefully weighing all the pros and cons, being in full confidence that in the future you will no longer want to become a mother.

Features of the dressing

There are 4 types of tubal ligation surgeries:

Laparoscopy. Two small punctures are made in the wall of the peritoneum, the necessary instruments are inserted through them, and for better visibility, the abdominal cavity is filled with carbon dioxide (CO 2).
Laparotomy. The abdominal cavity is opened using a suprapubic or median incision.
Minilaparotomy. It is performed through a small (no more than 3 cm) incision above pubic articulation.
Hysteroscopic and colpotomy accesses. All manipulations are carried out directly through the vagina, without the need for abdominal incisions.

For caesarean section, the second method is used predominantly, occasionally the first. Plus ligation of the fallopian tubes in this situation in the absence of the introduction of an additional dose of anesthesia. The operation takes an average of half an hour.

Various techniques may be used during surgery, including:

cauterization + installation of plastic or metal clips (clips);
coagulation - laser soldering of the tubular channel;
tugging with a silk ligature;
blockage of pipes embedded inside implants.

Tubal ligation surgery techniques

The postoperative period when using laparotomy lasts 7-10 days. After the condition of the woman in labor stabilizes, the stitches are removed.

Consequences of tubal ligation during caesarean section

The main disadvantage of the procedure is zero fertility. On the one hand, women go for a dressing just for this purpose, but on the other hand, life circumstances can change dramatically, and a lady will regret the decision she once made. According to statistics, 50% of patients who have undergone a sterilization procedure would like to turn back the clock. But the probability of getting pregnant after ligation of the fallopian tubes, even through is negligible, which is why strong arguments are always needed to carry out such an operation.

If the doctor who performed the surgical sterilization is sufficiently experienced and qualified, and sterility and all necessary norms, any consequences of dressing are excluded. Unless at first a woman will feel dizzy, nausea (the result of anesthesia), bloating and cramps, pain in the area of the incisions. All these are local and short-term symptoms.

If the manipulation was performed poorly, the following conditions, effects and complications may occur:

Ectopic pregnancy(if the fallopian tubes are tied loosely, and a small lumen leaves access for the spermatozoon).
Inflammation.
Adhesion processes.
Damage to nearby internal organs, in particular, the uterus, ovary, etc.
Absent-mindedness, memory impairment, intense hair loss, deterioration in the structure of the skin - as individual consequences of anesthesia.

It is important not to forget about the aesthetic component - in any case, the procedure will lead to the appearance of scars of different dimensions on the skin.

What you should pay attention to

The percentage of possible failure of the procedure is negligible, which is why it is considered irreversible. Young ladies ligate the fallopian tubes, who do not doubt the need for themselves DHS, otherwise, it is worth replacing the discussed method of contraception with a more traditional or sparing one.

In the case when a woman has experienced the described procedure in the process of caesarean, consequences other than those arising after childbirth should not be expected. Sterilization does not affect the production of milk, is not a contraindication for further feeding of the child. The blockage of the uterine canals does not affect the processes and specifics of ovulation / menstruation, the intensity of libido, so the information that the lady then quickly ages and gains weight does not interest her any more - an obvious myth. The ovum of the young ladies, who were bandaged with a paired tubular organ, continues to mature in the usual rhythm, critical days come regularly, and the menopausal period occurs according to age and individual characteristics.

Conclusion

It is important to be clear when tubal ligation is done. One female desire is not enough for a doctor to apply this method contraception. A gynecologist can tie the tubes during a caesarean section operation only if there are certain kinds of contraindications for another pregnancy of the patient and she has previously signed a number of legally confirmed documents. The procedure is safe, but its irreversibility should be the basis for making a balanced and reasoned decision.

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Tubal ligation is currently one of the most effective methods contraception. The procedure is recommended for women over 35 who have two or more children and do not plan to become pregnant in the future. After tubal ligation, pregnancy in a natural way is not possible.

Tubal ligation is performed by surgical intervention. The operation may be recommended by a doctor for health problems, when a woman is contraindicated in pregnancy in principle. Like any other operation, the procedure has drawbacks and can lead to unpleasant consequences, which we will discuss in this article.

First of all, we will answer the question of what is tubal ligation. This is an operation that breaks the patency of the fallopian tubes and prevents pregnancy.

The fallopian tubes connect the uterus and ovaries on both sides, they fertilize the egg and move it to the uterus in the future. Tubal ligation prevents this process and pregnancy does not occur.

Currently, there are several ways to carry out the operation. The fallopian tubes can be tied, cut and clipped. The latter option is unsafe, as the clip can come off, which can lead to the restoration of tubal patency and pregnancy.

Tubal ligation. Source: newgyn.ru

The operation can be carried out by laparoscopy, that is, through a small hole, or by the classical method using a scalpel incision. The first method is less traumatic, there are no large scars, and the rehabilitation process is minimal. There is also a method of performing the operation through the vagina, in which case only the inner seam remains, there will be no external scars on the body.

Which method to choose, the specialist can tell. So in the presence of infectious diseases or cysts, it will be necessary not only to ligate the fallopian tubes, but also to carry out treatment. In this case, the doctor will have to use a scalpel. And the vaginal method, although it does not leave scars, can cause infectious diseases, and after the operation, sexual contacts are prohibited for a month.

Advantages and disadvantages

Tubal ligation is a serious step, so before carrying out the procedure, you need to study all its pros and cons. If the ligation of the fallopian tubes in a woman is carried out in accordance with all the rules and in the absence of contraindications, then the likelihood of negative consequences will be minimal.

Consider the main advantages of the procedure:

tubal ligation does not provoke hormonal disruptions;
high level of protection against unwanted pregnancy;
menses persist;
tubal ligation does not affect a woman's libido;
tubal ligation may be performed during a caesarean section;
the procedure does not contribute to weight gain.

The disadvantage of tubal ligation in women is the impossibility of natural conception in the future. If a woman wants to become a mother after tubal ligation, she will have to go through the IVF procedure.

It is also worth noting that this method of contraception will not be able to protect against sexually transmitted infections. Therefore, if a woman is not sure about her partner, she will have to use condoms without fail so as not to get infected.

There is such a thing as the restoration of the fallopian tubes after ligation. Such an operation does not always bring the desired result, it all depends on the method of tubal ligation. The procedure is complex, not every surgeon can do it, so it is very expensive and time-consuming.

Consequences

Despite many advantages, the procedure also has a number of significant disadvantages. First of all, this possible complications after operation. After surgery, bleeding, infection, pain in the lower abdomen and bloating, dizziness are possible. Side effects and unpleasant consequences after tubal ligation surgery are rare if the procedure was carried out according to all the rules.

Another unpleasant consequence after tubal ligation is an ectopic pregnancy. The probability of such an incident is small, but still it sometimes happens. Therefore, if a woman has not started her period after tubal ligation and she is not breastfeeding, it is necessary to take a pregnancy test and visit a gynecologist.

Many women notice that their periods become more abundant after tubal ligation. As a rule, the operation does not affect the hormonal background of a woman, and therefore cannot provoke problems with menstruation. If a woman is concerned about such a fact as heavy menstruation, pain during and before menstruation, it is recommended to consult a doctor and undergo an ultrasound scan.

In general, tubal ligation surgery is not difficult, it is performed in any gynecological hospital. Consequences occur quite rarely if a woman follows all the recommendations of a doctor, and at the first unpleasant symptoms she goes to an appointment. The only thing that needs to be well considered is whether the desire to have children will appear in a few years.

is a surgical operation during which the fallopian tubes are blocked, ligated or cut off. According to many experts, this is a reliable method of contraception, but there is still no 100% guarantee, and already a year after such an operation, 5 women out of 1000 can become pregnant, and after another 10 years - 18 women out of 1000.

Ineffective ligation occurs in the case of tubal fusion, when there is a passage into which spermatozoa penetrate, as well as in case of improperly performed sterilization.

To understand the essence of the operation, it is necessary to recall that reproductive system in women, it includes two ovaries, two fallopian tubes, a uterus, and a vagina. Normally, both ovaries are able to expel an egg ready for fertilization (this process is called ovulation). This phenomenon occurs on the 12-17th day. menstrual cycle monthly. The egg is released from the ovary into the fallopian tube and travels through it to the uterus due to muscle contractions and movements of small, hair-like cilia.

Types of surgery

Laparoscopy

Closing of the fallopian tubes or tubal sterilization can be done by laparoscopy with the introduction of a microscopic camera and a surgical instrument through a small incision made in the abdomen. The operation is done under anesthesia in two ways.

Laparoscopic dressing begins with gas injection into the abdomen to make the procedure more comfortable. The fallopian tubes are then sealed with a ring, clip, or electric current.

The upper section, as seen in the figure, is intended for the indicated device, and the lower one is for the clamp. The dotted line marks the sites of incisions.

Mini laparotomy

A mini-laparotomy ("mini-paw") involves removing part of the tube and sealing the remainder with sutures, tapes, clips, or electric current. Any woman over the age of 35 who does not want to give birth again can use this method of protection against unwanted pregnancy. This method of contraception is irreversible, does not allow you to conceive a child naturally, so this decision should be well thought out. Both fallopian tubes are crossed in a woman.

A mini-laparotomy is performed through an incision that is less than five cm long. As part of the operation, the surgeon makes two minor incisions. One of them falls on the pubic area. This type of intervention allows you to permanently prevent the onset of pregnancy.

An open laparotomy is performed through a significant incision in the abdomen.

An abdominal operation is required for the purpose of a caesarean section;

Have pelvic inflammatory disease, endometriosis, or require pelvic surgery for another reason.

In some cases, resort to postpartum tubal ligation. Since in this case the fallopian tubes are located higher in the abdominal region, the incision is made below the level of the umbilicus. It is best to carry out the operation in the first one and a half days after the birth of the child. Because after 48 hours, the uterus shrinks, and postpartum tubal ligation will be much more painful and problematic.

It should be noted that laparoscopy is usually performed under general anesthesia. But all forms of this operation can be carried out not only under general, but also under local (epidural) anesthesia.

Tubal implant method

Implants are introduced into the area of the fallopian tubes without surgery and without anesthesia. It takes no more than half an hour, before the start of the operation, the woman should sit in a chair, as usual at a gynecologist's appointment. First of all, the cervix should open - this will help avoid damage to it.

Next, the specialist introduces a catheter through the vagina into the cervix, then into the organ cavity, and then into the fallopian tube: first into the first, and then into the second. A catheter is used to place implants in the tubes. In some cases, spasms similar to occur during the procedure.

Over time, a scar tissue forms, which grows near the implants and overlaps the fallopian tubes. The presented type of operation makes it possible to prevent the removal of the egg from the ovaries into the fallopian tubes. As you know, it is in them that fertilization becomes possible.

To make sure that the pipes are securely closed, it is necessary to take an x-ray. In the first three months after implantation, it is recommended to change the method of contraception. At the end of this period, a dye is introduced into the area of \u200b\u200bthe uterus and an x-ray examination, or hysterosalpingography, is again performed. This will make sure that the implants have not moved and the tubes are 100% blocked by scar tissue.

Operation with an incision of the suprapubic zone

Conventional surgery with an incision in the suprapubic area of the abdomen requires a long stay in the clinic. After the operation is formed. With a culdoscopic operation, which is a puncture of the posterior wall of the vagina, no scars remain, there are no complications, and tissue heals quickly. It is known that such sterilization does not cause hormonal disturbances, libido and a normal menstrual cycle are preserved.

Mature eggs are absorbed in the abdominal cavity, and women have no fear of a possible unwanted pregnancy. As a rule, most patients prefer postpartum sterilization, which is performed immediately after childbirth. The operation usually takes less than 30 minutes and does not require a long hospital stay. Women after such a procedure may experience minor pain and cramps in the abdomen, decreased physical activity, and nausea.

Should I use this method of contraception?

Tubal ligation is a radical type of contraception that is almost impossible to reverse in the future.

Voluntary sterilization is allowed for women of reproductive age who already have at least one child and do not want to have children in the future. Tubal ligation is indicated for a number of diseases that can pose a threat to life and health during pregnancy.

Many women have contraindications to taking hormonal contraceptives and the use of intrauterine devices, then sterilization becomes the only reliable means of protection. Tubal ligation is highly effective and is the most popular method of contraception among mature couples with children. However, a serious complication of sterilization is an increased risk of ectopic pregnancy.

Although doctors warn that tubal ligation is irreversible, and ask for good thought before doing it, if necessary, you can try to restore the functions of the tubes, after which pregnancy occurs in 60-80% of women. These are microsurgical operations that take place under general anesthesia, the difficulty arises with the reunification of the dissected ends of the fallopian tubes.

Before you make a decision, you should be aware of the statistics that show that many women who have had tubal ligation surgery regret it. Science does not stand still, and today a new, simpler and safer method has been developed that does not require intervention in the abdominal cavity. Its essence is the introduction of various drugs or devices into the uterus that cause local damage and an inflammatory reaction, as a result of which the connective tissue grows and the fallopian tubes become impassable.

The effectiveness of this method is more than 99%, but it is not yet used in clinics in the CIS countries.

The most reliable way is to simply cut the pipe with a scalpel or an electric knife, after which a puncture is made with a needle with a nylon ligature in two places of the pipe in its middle part. The ends of the threads are tied and cut off. Also no less reliable is sterilization by the type of resection of a part of the tube with immersion of its ends under the peritoneum.

What to expect after surgery?

After tubal ligation

After a successful tubal ligation, the patient returns to normal life within a day. However, minor bleeding from the vagina may occur. After laparoscopy is completed, abdominal distention is noted due to the gas used to lift the skin and muscles above the peritoneal organs, which is necessary for the operation. This effect usually wears off within a few days.

It is likely that there will be pain in the back or shoulders due to gas in the abdominal cavity, which will also pass after the gas is fully absorbed. It is permissible to take a shower a day after the operation, but without rubbing and other influences during the week.

Full recovery of the body after tubal ligation occurs after about 7 days.

Besides:

You can have sex if there is no pain;

There is no need for an additional method of birth control.

After implant placement

After the implants are inserted, women return to their daily activities within a day. Precautions include using another method of contraception for three months and until an absolute blockage of the fallopian tubes is confirmed by X-ray.

How effective is such an operation?

Tubal ligation at the entrance to the uterus, as well as the introduction of implants, cannot be considered one hundred percent effective methods for preventing unwanted pregnancy.

There is a relatively small chance of getting pregnant after the tubes have been tied in this way. Five out of 1000 women experience this 12 months after surgery. 10 years after the intervention, at least 18 out of 1000 may already be in position.

This can happen if:

The tubes have grown together or a new passage has formed through which the egg will be fertilized by the sperm;

The dressing was done incorrectly;

The woman was already pregnant at the time of the operation.

What if tubal implants were used? This method does not have long-term statistics, since it is relatively new. Ongoing studies show that less than one in 100 women with implants become pregnant in two years.

Reasons for visiting a specialist

You should immediately consult a doctor if symptoms of pregnancy are noted. This may be a failure in the menstrual cycle, increased sensitivity of the breast, as well as nausea. Causes for concern should be considered pain on either side of the lower abdomen, loss of consciousness and dizziness.

Risks and complications after bandaging

Tubal ligation is characterized by the fact that after it no severe complications are formed. Less serious consequences include infection and dehiscence. It occurs in 11% of women after mini-laparotomy and in 6% after laparoscopy. More serious complications include tangible and dangerous blood loss, problems that are provoked by general anesthesia, as well as damage to organs during the operation and the need for even more significant incision.

Although there are fewer complications with laparoscopy than with other types of tubal ligation surgery, these complications can be more threatening. For example, when inserting a laparoscope, damage is likely Bladder or intestines. The risk within the operation increases if the woman has nicotine addiction or cardiovascular disease.

Risks and complications after tubal implants

After implantation, pain in the pelvic area may not go away. In such situations, the implants are removed six weeks after insertion into the fallopian tubes. This increases the risk of developing diseases of the pelvic organs. Before the implementation of the intervention, it is recommended to undergo an examination. This will make it possible to make sure that the patient does not have infectious diseases of the reproductive system.

The risk of developing an ectopic pregnancy

If the process of resection of the fallopian tubes or implantation was unsuccessful, and the woman nevertheless became pregnant, then her probability of forming an ectopic pregnancy increases many times over. This can happen several years after surgery, and most likely after three years or more.

What should you think about?

It is necessary to take into account the following points that are associated with tubal ligation and implant placement:

All methods of female contraception have their positive and negative sides; they do not completely protect against unwanted pregnancy. - the only reliable way to avoid conception, the procedure is carried out in an operative way.

Tubal ligation scheme

Pros and cons of the surgical method of contraception

Fallopian tube ligation is performed for medical reasons, when subsequent births are harmful to health, can cause severe complications, disability, death.

Less often, the operation is performed at the request of the woman herself in order to prevent pregnancy, after the procedure, the egg cannot meet with the sperm, which completely eliminates the possibility of conception.

Sterilization Benefits

Pros:

the probability of pregnancy is almost zero;
tubal ligation does not affect hormonal balance, sex drive, sensitivity, weight, lactation;
sterilization does not affect ovulatory function - the egg matures, menstruation comes on time, a slight violation of the cycle is sometimes observed within 1-2 months after surgery;
the procedure can be done immediately after a caesarean section, after childbirth.

The main advantage of the operation is the almost zero probability of pregnancy.

Flaws

Minuses- after surgery, there are consequences in the form of bleeding, inflammatory processes, if the technique is violated, the risk of tubal pregnancy increases. The operation is performed under anesthesia, which increases the number of contraindications.

It is possible to eliminate the consequences of female sterilization, restore the patency of the tubes with the help of plastic surgery, but they are expensive, they are carried out mainly in European clinics, there is no guarantee of a positive outcome. Sometimes they resort to the IVF procedure - this is also a complex, expensive process, severe stress for a woman, while reproductive specialists do not give a 100% guarantee of pregnancy.

According to the law, all women who want to undergo sterilization are given six months to think, since this process is irreversible, and subsequently it will not be possible to become pregnant.

Indications and contraindications for sterilization

At the request of a woman, a fallopian tube ligation is performed if there is at least 1 child, and she is already 35 years old.

Medical indications

When surgery is needed:

severe heart, kidney disease, lung pathology;
the presence of malignant neoplasms in the body;
decompensated diabetes, other genetic diseases and anomalies that can be transmitted to the child;
sometimes dressing is carried out with a second caesarean section;
severe mental problems - a woman must be recognized as incapacitated, the decision on sterilization is made in court.

In any case, the woman signs the consent to sterilization, formalizes it legally.

Contraindications

The operation is excluded in the presence of infectious, adhesive processes in the pelvic organs, obesity III, IV degree, some types of neoplasms. It is also not carried out in severe forms of general diseases, in which it is risky to administer anesthesia.

Most often, the operation is performed under general anesthesia, severe forms of some diseases are contraindications

In case of violation of the protocol of the operation, an incorrectly selected method of intervention, sometimes a natural restoration of the patency of the uterine vessels occurs.

Preparing for tubal ligation

Before the operation, the woman undergoes a comprehensive examination, conducts a conversation and consultation with her,.

Survey methods:

clinical and biochemical blood tests;
general urine analysis;
coagulation tests, group and Rh factor of blood;
blood test for HIV, sexual infections, hepatitis;
gynecological examination;
smear culture;
chest x-ray;
Ultrasound of the pelvic and abdominal organs.

Before the operation, it is necessary to undergo a gynecological examination

Many analyzes can be done in advance at the district clinic, but a coagulogram, smear analysis and is carried out necessarily immediately before surgery.

The last meal before the operation should be light, no later than 19 hours. Before transferring the patient to the operating room, she is given a cleansing enema.

How is the operation

Exist different methods ligation of the fallopian tubes, all operations are performed under general anesthesia, sometimes spinal anesthesia is performed, the average duration of sterilization is 30-60 minutes.

Laparoscopy

Laparoscopy procedure

The most popular tubal ligation technique, characterized by a short recovery period, can be performed under local anesthesia, after the operation, sutures and scars are practically not visible.

How to tie the pipes:

On the abdominal wall, the doctor makes a small incision, the necessary devices and instruments are inserted into it.
The abdominal cavity is filled with carbon dioxide to improve visibility.
The surgeon examines the internal organs of the reproductive system, reaches the tubes.
To disrupt the patency, a laser, electrocoagulation, photocoagulation are used, clips, staples, rings are used.
To avoid burns of surrounding tissues, the abdominal cavity is washed with saline.

After the end of the procedure, the woman is transferred to the ward, in the absence of complications, she is discharged after 2-3 days.

Minilaparotomy

A simple, inexpensive method of surgical intervention, does not require high qualifications from the surgeon.

Operation steps:

Under the pubic joint, the doctor makes an incision 2–3 cm long.
Examines the pelvic organs, finds tubes.
Cauterizes tissue or installs clips to disrupt patency.

This method of operation is used after childbirth, but it is not suitable in the presence of uterine fibroids, obesity.

Laparotomy

During laparotomy, the abdominal cavity is completely opened.

During the operation, a suprapubic or median incision is made, the abdominal cavity is completely opened. The operation has many disadvantages - a long recovery period, a high probability of developing infectious complications, noticeable scars, so they resort to it during or after a caesarean section.

You will have to spend 7-10 days in the hospital under the supervision of a doctor, after which the stitches will be removed.

Hysteroscopic and colpotomy access

Hysteroscopic access requires special equipment that allows you to influence the inner shell of the tubes by coagulation. The advantage is the absence of any incisions, the device is inserted through the vagina into the uterine cavity, then they move to the tubes, the woman is discharged from the clinic in a day.

Hysteroscopy procedure

Colpotomy access - make small incisions on the back of the vagina, go to the tubes, pull them into the hole. The part is excised, tied with surgical threads, or a clamp is placed, or cauterized, returned to its place, sutures are applied to the incision.

Advantage - low cost, disadvantage - high probability of infection.

Bandaging is carried out in the second phase of the menstrual cycle, 1.5 days after the abortion, 2–7 days after natural childbirth or during a caesarean section.

Recovery after surgical sterilization

After surgery, it is necessary to abandon excessive physical activity, new life, you can not lift weights. For several days, baths are contraindicated, you can take a warm shower, use laundry soap to care for the intimate area, but you can’t rub the genitals intensively.

Adverse reactions after sterilization are rare.- minor bleeding, lower back pain and bloating after laparoscopy. 2 weeks after the operation, it is necessary to undergo an examination by a gynecologist.

Where to do it and how much does it cost?

If you have a policy in municipal medical institutions female sterilization is carried out free of charge, all the main costs are covered by the state.

If you have a policy, female sterilization will be carried out free of charge

The operation is done for a fee in private clinics, or in public ones, choosing more convenient conditions for being in a hospital. Many factors affect the cost of sterilization - the level of the medical institution, the qualifications of the doctor, the method of intervention, the type of anesthesia. Average price - 10-50 thousand rubles.