Tubal ligation or tubectomy (also known as having "bound tube ") is a surgical procedure for sterilization in which female fallopian tubes are clamped and blocked and sealed , one that prevents the egg reaching the uterus for implantation. Tubal ligation is considered a method of sterilization and permanent birth control.
Video Tubal ligation
Prosedur
Tubal ligation (mistakenly referred to as tubectomy) is considered a major surgery, usually requiring the patient to undergo local, general, or spinal anesthesia. It is recommended that women should not undergo this surgery if they currently have or have a history of bladder cancer. After the anesthesia begins to work, a surgeon will make a small incision on each side, but just below the navel to gain access to each of the two fallopian tubes. With traditional tubal ligation, surgeons cut the tubes, and then bind (ligates) them thus preventing the journey of eggs to the uterus. Other methods include using clips or rings to pinch them, or breaking and burning them. Tubal ligation is usually done in the hospital operating room.
Maps Tubal ligation
Effectiveness
Tubal ligation is approximately 99% effective in the first year after the procedure. In subsequent years its effectiveness can be reduced slightly because the fallopian tubes can, in some cases, reform or reconnect which can lead to unwanted pregnancies. Failure methods are difficult to detect, except by subsequent pregnancies, unlike vasectomy or IUD.
Of these failures, 15-20% are likely to be ectopic pregnancies. 84% of such failures occur a year or more after sterilization. According to a study, about 5% of women who have tubal ligation will experience failure due to ectopic pregnancy. Time seems to be a factor because the risk of failure increases after 1 or more years postoperatively. The risk of ectopic pregnancy is 12.5% ​​for women who have tubal ligation, which is a greater risk than those who have not undergone surgery. Rekanalisasi or formation of tuboperitoneal fistula occurs, the opening is large enough to pass through the sperm but is too small to allow the egg to push through, resulting in fertilization/implantation in the distal tubal segment.
Two economic studies show that bilateral laparoscopic tube ligation can be less cost-effective than the Essure procedure, which uses a special fiber type to induce benign fibrotic reactions.
Methods of tubal ligation
Bipolar Coagulation The most popular method of sterilizing laparoscopic women, this method uses an electric current to burn the fallopian tube section.
Monopolar coagulation Less common than bipolar coagulation, monopolar coagulation uses electric current to burn the tubes together, but also allows emitting currents to further damage the tubes as they spread from the coagulation site. Many cases involve tube cutting after the procedure.
Fimbriectomy By removing some of the closest fallopian tubes to the ovary, the fimbriectomy removes the ability of the fallopian tubes to catch the eggs and transfer them to the uterus.
Irving Procedures This procedure requires two ligatures (stitches) around the fallopian tube and removes the tubing segment between the ligatures. Then to complete the procedure, the end of the fallopian tube is connected to the back of the uterus and connective tissue respectively. This method was pioneered by the American Obstetrician, Frederick Carpenter Irving (1883-1957) in 1924.
Tubal clips Tubal clips (Filshie clips or Hulka clips) involve the application of a permanent clip to the fallopian tube. Once applied and tightened, the clip does not allow the movement of eggs from the ovaries to the uterus.
The tubular ring The silastic band or tubular method involves multiplying the fallopian tubes and applications of the silica tape to the tubes.
Pomeroy tubal ligation In this tubal ligation method, the loop of tube is "strangled" with stitches. Usually, the loop is cut and the tip is burned or "burned". This type of tube ligation is often referred to as cut, tied, and burned. This method was developed by the American Gynecologist and Surgeon, Ralph Hayward Pomeroy.
Essial tubal ligation In this method tubal ligation, two small metals and fiber rolls are placed in the fallopian tube. After insertion, scar tissue forms around the coil, closing the fallopian tube and preventing the sperm from reaching the egg.
Adia tubal ligation In this tubal ligation method, two small pieces of silicon are placed in the fallopian tube. During the procedure, the health care provider heats a fraction of each fallopian tube and then inserts a small piece of silicon into each tube. After the procedure, scar tissue forms around the silicone insertion, closes the fallopian tube and prevents the sperm from reaching the egg. This procedure can no longer be done because of the lawsuit and consideration filed by the company responsible for Essure.
Inversion
Tubal ligation procedures are performed to be permanent and are not considered to be a temporary form of birth control. Tubal inversion is micro surgery to repair fallopian tubes after tubal ligation procedures.
Usually there are two segments of the remaining fallopian tubes - the proximal tube segment arising from the uterus and the distal tubal segment that ends with the fimbria next to the ovary. The procedure that connects the separate parts of the fallopian tube is called tuba reversal or micro tubotubal anastomosis.
In a small percentage of cases, tubal ligation procedures leave only the distal portion of the fallopian tube and no proximal tube opening to the uterus. This may occur when monopolar tubal coagulation has been applied to the fallopian tube ismic segment as it emerges from the uterus. In this situation, a new opening can be made through the uterine muscle and remaining tubal segments inserted into the uterine cavity. This microsurgical procedure is called tubal implantation, tubouterine implantation, or uterotubal implantation.
In vitro fertilization can overcome fertility problems in patients who do not fit the tubal inversion.
Side effects
A 1998 review of more than 200 articles in English literature suggests that evidence of post-tubal sterilization syndrome (abnormal bleeding and/or pain, changes in sexual behavior and emotional health, increased premenstrual pressure) alias post tubal syndrome, women over 30 years old. The risk for women aged 20-29 with a history of pre-existing menstrual disorders may increase, "although they do not appear to have significant hormonal changes". A 1993 study conducted in Japan found symptoms of post-tubal ligation syndrome to be mild, and simple symptomatic treatment became sufficient in many cases. Cessation of hormonal birth control has its own side effects, many of which are also often associated with post-tubal sterilization syndrome.
Prevalence
Worldwide, female sterilization is used by 33% of married women using contraception, making it the most common method of contraception. In June 2010, there was a recent decline in tubal ligation procedures in the United States after two decades of stable levels, perhaps explained by increased access to highly effective reversible contraceptives.
Advantages and disadvantages
Tubal ligation is a stomach operation. One study found that postoperative complications of tubal ligation were more likely than vasectomy and more expensive. In industrialized countries, the mortality rate is 4 per 100,000 tubal ligations, compared to 0.1 per 100,000 vasectomy.
Tubal ligation has a higher initial cost than other contraceptive methods. It may take more than a decade of use for tubal ligation to become cost effective such as other highly effective long-term methods such as IUDs or implants. The cost of advanced methods or the cost of unwanted pregnancies makes many other methods as or more expensive than tubal ligation if used for several years. The cost of tubal ligation is reduced if performed during caesarean section, since the tube is already open during laparotomy.
Tubal ligation may reduce the risk of ovarian cancer, with some studies estimating relative risk at 0.66 for epithelial type, 0.40 for endometrioid type and 0.73 for serous type.
Recent tubal ligation (sterilization) policies in the United States impose mandatory waiting periods for elective tubal sterilization in Medicaid recipients. In the absence of such periods for private beneficiaries, some doctors and scientists believe that "this decades-long postponement policy has a good purpose but now has had the effect of restricting women's access to elective tubal sterilization and injustice".
References
External links
- The 2008 Birth Control Comparison Chart
Source of the article : Wikipedia
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