Tubal ligation reversal

Tubal ligation reversal is a procedure undertaken by women, who after having a tubal ligation decide they would like their fertility restored. Most commonly women have the procedure performed with the aim of becoming pregnant again, however the surgery may also be performed if a women is suffering from "post tubal ligation syndrome", a condition which affects some women after having their tubes ligated and can cause many discomforting and potentially damaging symptoms. Tubal ligation reversal is a surgery preferred by many women as it allows pregnancy to occur naturally, as opposed to other fertility treatments such as "in vitro fertilisation".

The tubal ligation reversal procedure

There are several factors that may affect a women’s suitability for a tubal ligation reversal. As the tubal ligation procedure itself may be done in several different ways it is important for patients to provide their surgeon with all the relevant information regarding their original tubal ligation surgery. The most suitable patients are those women who have only had a small part of their fallopian tubes removed, or women who have had their fallopian tubes closed with a clip or ring. This is because the diameter of the fallopian tube decreases as it descends from the ovaries to the uterus so if a large portion has been removed the difference in diameter between the two free ends makes it more difficult to reconnect them. Age is also a significant factor (the higher your age the smaller the chance of success) so women should discuss their any concerns with their physician before proceeding with the operation.

The procedure itself is usually done laparoscopically under local anaesthetic and takes an hour to complete. Open surgery may be performed in which case general anaesthetic is used .The abdomen is inflated by filling it with gas creating a larger space in which the surgeon can operate. A stent is then extended from the ovaries to the uterus ensuring that the fallopian tubes remain open while they are reconnected. Sutures are then used to pull the two free ends of the fallopian tubes together and reconnect them. A blue dye is then passed through the fallopian tubes to ensure that the connection has been successfully re-established.

After your tubal ligation reversal operation

Recovery time is minimal with most women being discharged about 5 hours after their operation. There may be cases, usually when open surgery is performed, where patients are required to stay in hospital for up to three days. Patients are seen again 5 -7 days after the operation to inspect the incisions and to remove any stitches that still remain, however most stitches are reabsorbed by the body and will not require removal. Full recovery should be expected after six weeks. Women are advised not to attempt pregnancy until the fallopian tubes are completely healed, a process which takes up to three months. If pregnancy is attempted before such time the chances of an ectopic pregnancy, that is a pregnancy which develops inside the fallopian tubes as opposed to in the uterus, is greatly increased.

Long term outcome

The chance of becoming pregnant following a tubal ligation reversal varies greatly and depends on many factors. As mentioned above, success is most significantly influenced the age of the patient and the way in which the fallopian tubes were originally ligated. Typical success rates fall in the region between 20% - 70% with some clinics boasting success rates of up to 90%.

Complications with tubal ligation reversal

Complications following a tubal ligation reversal are very rare however as the procedure is a major operation there is some risk involved. Such risks include the risk of an infection, excessive bleeding, damage to surrounding organs, or problems with anaesthetic.

Tubal ligation reversal costs

The costs for a tubal ligation reversal are typically $15,000 - $20,000 - slightly more expensive than having IVF treatment. As there are several ways to restore fertility women should carefully consider all options before undergoing surgery.

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