07 Apr Tubal Ligation
“Tie the tubes” or tubal ligation is a procedure in which the female is sterilized. It is an operation that severs the fallopian tubes; this means the egg can no longer be fertilized by the sperm through sexual intercourse.
In Singapore, the procedure is usually performed under general anaesthesia (put to sleep). It can be performed by the following ways:
- Laparoscopy: One or two small incisions (cuts) are made in the abdomen at the navel, and a device similar to a small telescope on a flexible tube (called a laparoscope) is inserted
- Mini-laparotomy: this involves a slightly larger opening than for laparoscopy and takes a longer time to recover.
Once the abdomen is entered, the fallopian tubes are burned or sealed with clips or cut. The skin incision is then stitched closed. The patient is able to return home within a few hours or a day after the procedure.
Tubal ligation can also be performed immediately after childbirth through a small incision near the navel or during a caesarean section.
Except in rare instances, tubal ligation is 99.9% effective. It fails if the tubes that have been cut join up later on. The patient can get pregnant immediately or several years after a failed ligation. In this situation, there is increased chance of ectopic pregnancy.
The procedure is meant to be permanent, although it can be reversed by means of microscopic surgery. There is no guarantee of success. There are usually no long-term side effects. Occasionally, patients may have heavier or irregular menstruation. There is no evidence that it affects sexual drive.
A recent method, known as hysteroscopic sterilization, does not involve making any cuts. The gynaecologist inserts a tiny titanium coil into the fallopian tubes through the vagina and womb. Scar tissue then grows around the coils and blocks the tubes. This method is irreversible.