Getting Your Tubes Tied

Surgical Tubal Ligation Options

Getting Your Tubes Tied
Getting Your Tubes Tied. Steve Debenport/Vetta/Getty Images

You may have heard people mention that they have had their tubes tied. But what does this actually mean? Do doctors actually tie your tubes -- like in a bow or a knot? Let me clear this up for you.

Having Your Tubes Tied = Tubal Ligation

Tubal ligation is a permanent form of contraception. Getting your tubes tied is another way of saying that you have had a tubal ligation. This is a surgical tubal ligation procedure that closes off your fallopian tubes.

Once the tubes are sealed, sperm will not be able to get to and fertilize an egg -- this then means that you can't get pregnant.

Are My Tubes Actually Tied?

Maybe... you can have your tubes tied in several ways. Your doctor can seal your tubes during a tubal ligation by:

  • Clamping them with rings, clamps, or clips.
  • Cutting and sealing them shut with an electric current (electrocautery).
  • Tying your tubes, cutting them, and then stitching or electrically sealing them.

Okay, so I get that these options sound a little painful, but you will not be awake during your tubal ligation. If you are totally opposed to having your tubes tied surgically, there is a non-surgical permanent birth control option called Essure.

Surgical Tubal Ligation Options:

Your health may determine which surgical tube tying procedure is best to have. Your doctor will consider your body weight and whether or not you have had previous abdominal surgery.

The following are the different surgical options for having your tubes tied:

1. Laparoscopy:

Laparoscopic sterilization is one of the two most common methods of having your tubes tied. During this procedure, a little incision is made in or near your belly button to allow for a laparoscope (a small, telescope-like instrument with a light) to be inserted.

This allows for the surgeon to see your fallopian tubes. The surgeon may insert another device through the laparoscope to seal your fallopian tubes (or will tie your tubes through another small incision). Then the incision(s) is closed. A tubal laparoscopy procedure only takes about 30 minutes. There is usually minimal scarring, and you will most likely get to go home the same day.

2. Mini-Laparotomy:

A mini-laparotomy (or mini-lap) is the other most common method of having your tubes tied. Most women will have this procedure done right after giving birth. During a postpartum mini-laparotomy, the surgeon makes a small incision just below the belly button. Because the uterus is still enlarged from being pregnant, the fallopian tubes are right at the top of the uterus -- which is located just under your belly button. The fallopian tubes are then pulled up into or out of the incision and closed off.  The tubes are put back into place, and the incision is stitched shut.

3. Laparotomy:

A laparotomy procedure (also known as an open tubal ligation) is considered to be major surgery -- so it is not used as commonly as laparoscopy and mini-laparotomy.

The surgeon will make a larger incision (about 2 to 5 inches) in the abdomen. The fallopian tubes will then be pulled up into or out of the incision, closed off/sealed shut, and put back into place. The incision will then be stitched closed. An open tubal ligation is usually performed right before or after some other type of unrelated abdominal surgery, such as a Cesarean section.

4. Culdoscopy and Colpotomy:

Culdoscopy and colpotomy are two types of incisions that are used during vaginal sterilization approaches. Having your tubes tied by a vaginal method was once the preferred technique. But, since culdoscopy and colpotomy have higher risks, laparoscopic surgery is now the more common way to have your tubes tied. Your doctor may choose to do a culdoscopy or colpotomy if you are obese (or very overweight) or if you have a retroverted uterus. Both of these are small incisions made into vaginal wall -- but they may be more difficult to perform because you must be in lithotomy position (legs in stirrups) while under anesthesia.

5. Hysterectomy:

A hysterectomy is a procedure to where your uterus is removed. It is also considered to be major surgery. A hysterectomy is technically not a tubal ligation procedure. But, once your uterus is removed, there is nowhere for an egg to implant (so you cannot become pregnant). A hysterectomy can be performed through the vagina (vaginal hysterectomy) or abdomen (abdominal hysterectomy).

Medical and Non-Contraceptive Advantages of Getting Your Tubes Tied:

If you have surgically had your tubes tied, you may have also gotten an extra medical benefit. Research has shown that a tubal ligation lowers your risk for ovarian cancer. Having your tubes tied can reduce your risk of ovarian cancer by about 30%. Although the exact reason for this is unknown, the two main theories suggest:

  • When you have your tubes tied, the blood supply to your ovaries is interrupted. This may alter your hormone levels, which results in the reduced risk of ovarian cancer.
  • The closing off of the fallopian tubes may, perhaps, protect the ovaries from environmental agents that could cause cancer.

One last added benefit... having your tubes tied may also lower your chances of having pelvic inflammatory disease (PID).

Source:

Rice MS, Murphy MA, Tworoger SS. "Tubal ligation, hysterectomy and ovarian cancer: A meta-analysis." Journal of Ovarian Research. 2012; 5(1):13-28. Accessed via private subscription.

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