Tied the tubes after a caesarean. Tubal ligation in women: consequences, reviews, side effects. Regarding the disadvantages of this procedure

The tubal ligation procedure is a radical and highly effective method of surgical contraception. The purpose of the operation is the formation of artificial obstruction of the fallopian tubes. To do this, they are bandaged, clamped, blocked, cut. As a result, a mature egg is not able to penetrate into the fallopian tube for fertilization by a spermatozoon and further into the uterus, which ensures a high contraceptive effect of the procedure.

According to Russian law, this surgical intervention is performed with the voluntary consent of the woman and for medical reasons. Her age (from 35 years) and the presence of children (from two) are taken into account.

When conducting a procedure for medical reasons, these criteria are not taken into account. Before deciding on sterilization, it is necessary to weigh all the pros and cons of tubal ligation surgery for a woman.

The procedure is radical and means the impossibility of conceiving a child in the future. In some cases, its reversibility and restoration of the fallopian tubes after ligation is possible, but the likelihood of pregnancy is low.

pros

The question of choosing an effective method of contraception is always relevant in gynecological practice.

The tubal ligation technique has the following advantages:

High contraceptive effect. Compared with other methods of preventing unwanted pregnancy, this method is considered the most reliable. The effectiveness of the procedure tends to 100%.
There is no effect on the balance of hormones in the body. As a result, libido is not disturbed, general well-being, weight remains at the same level, the cyclicity of menstruation does not change.
With a properly performed operation, the risk of side effects is minimized, the general health of the woman does not suffer.
It is possible to perform an operation with a caesarean section, which eliminates the need for additional surgical interventions. Tubal ligation after childbirth is acceptable.

Minuses

Since tubal ligation is an invasive and radical method of contraception, it should be used after weighing all the pros and cons thoroughly.

The disadvantages of the method include:

Invasiveness of the procedure, the need for anesthesia.
Pregnancy after tubal ligation is not possible. According to statistics, more than half of the sterilized women would like to regain their reproductive ability. In some cases, surgery may be performed to restore patency. However, the chance of pregnancy remains low.
Possible postoperative complications: bleeding, pain, inflammation, symptoms of general malaise (weakness, dizziness, nausea, vomiting, etc.).
risk of ectopic pregnancy. It usually occurs in violation of the technique of the operation (incomplete clamping of the tubes).
Sterilization is not protection against genital infections.

Indications

Tubal ligation at the request of a woman over the age of 35 with two or more children, absolutely sure of her unwillingness to have more offspring.
Severe diabetes mellitus.
Heart defects, accompanied by pulmonary hypertension and circulatory failure stage II-III.
Severe pathologies of the kidneys, liver, lungs, etc.
Oncological diseases.
It is possible for a court to decide on sterilization in relation to a woman with a severe mental illness, recognized as incompetent.
Multiple cesarean section in the presence of live children.
Severe genetic pathology that can be transmitted to offspring.

Contraindications

Contraindications for surgical sterilization are:

uncertainty in making a decision about the operation;
inflammatory conditions of the pelvic organs;
the presence of pregnancy;
obesity 3-4 degrees;
pronounced adhesive process;
neoplasms of the genital organs, large intestine;
serious diseases that pose a threat to the health and life of a woman during the use of anesthesia and surgery;
acute infectious diseases;
mental retardation.

If you want to perform tubal ligation after childbirth, contraindications are:

anhydrous period of more than 12 hours;
bleeding;
preeclampsia or eclampsia during childbirth.

In these cases, the operation may be carried out later.

Dressing techniques

In gynecology, there are quite a few methods for performing tubal ligation. To create their artificial obstruction, the following methods are used.

Ligation with suture material, excision of a fragment of the fallopian tube.
Use of rings, clamps, clips. Less radical way. Perhaps the restoration of the ability to conceive, if desired, untie the fallopian tubes after ligation.
Coagulation using ultraviolet, electric current, laser.
Installation of tubal implants.

Sterilization methods are used in various methods of tubal ligation. The choice is made on the basis of an assessment of the risks and benefits, effectiveness, technical aspects of the procedure.

By Madeleineer

When ligating the fallopian tubes according to Madlener, a loop is formed from them, part of which collapses at the base and is tightened with a thread (non-absorbable). However, at present, this method is considered untenable, since it often failed due to the formation of fistulas at the site of ligation.

According to Irving

During caesarean section, the fallopian tube is dissected at the site of the ampullar-isthmus junction, the distal stump is immersed inside the broad ligament, the proximal stump - into the myometrium. After childbirth, with the involution of the uterus, the immersed ends are gradually obliterated. Pregnancy in the proximal stump is excluded.

Pomeroy

This method is most often used in surgical sterilization. The tube is grasped in the middle segment with a Babcock clamp. Then this area 2 cm long is tied with absorbable thread at the base. The segment is subject to excision, after which it is sent for research. Excision and use of absorbable sutures allows separation of the distal and proximal areas, which reduces the likelihood of recanalization. The method is easy to implement and effective.

By Yumida

Complex sterilization technique. Separation of the muscular and mucous tissues of the tube is performed by injecting epinephrine in saline into the submucosal tubal epithelium. After that, the mucous membrane is separated from the muscular tube, the section of the tube is removed (5 centimeters). The proximal segment is ligated and immersed in the mesentery of the fallopian tube, closed with a purse-string suture, and placed adjacent to the distal end. This technique is difficult to implement, but is one of the most reliable.

By Pritchard

The mesentery of each fallopian tube is excised in the avascular segment, then alloyed in 2 places with chromic catgut, the area between them is excised. The technique allows you to save a significant part of the pipe, to prevent recanalization.

Clips Filshi

Devices are superimposed on the tubes at a distance of about 2 centimeters from the uterus. The technique is usually used in the postpartum period. Place the clips slowly to remove edematous fluid from the tubes.

Fallopian rings

This method of sterilization is performed by applying an annular bandage. This is a simple and inexpensive way, which consists in clamping the pipe elbow with a bandage. The pinched pipe elbow is not removed.

Application of tubal implants

During the operation, monitoring is carried out using ultrasound. Bypassing the cervix and uterine cavity, catheters are placed in the fallopian tubes, forming an obstruction. The procedure is performed using local anesthesia. The fusion of the tube occurs over 3-4 months. After that, the patency is monitored by hysteroscopy, hysterosalpingography.

Training

After the decision to conduct surgical sterilization, the woman is assigned the following preparatory measures.

Consultation and examination by a gynecologist, analysis of a smear from the vagina and uterine cervix.
Conducting ultrasound of the pelvis, including to exclude pregnancy.
General blood tests, urine, biochemistry.
Determination of blood group, Rh factor, hemostasiogram.
Testing for HIV, syphilis, hepatitis.
ECG, fluorography, according to indications - ultrasound of the abdominal organs.
The day before sterilization, a cleansing enema is performed, the patient must take hygiene procedures, do not eat and drink 8 hours before the intervention. The operating surgeon and the anesthetist are talking to the woman. It is possible to prescribe sedatives.

At the stage of preparation for the operation, a woman has the right to refuse the intention to ligate the fallopian tubes or to postpone the decision. Before surgery, the patient must provide written consent to its implementation.

Operation technique

The choice of the operation technique for tubal ligation and the type of anesthesia is carried out based on the analysis of the woman's history, the reasons for sterilization, the qualifications of the staff, and the availability of equipment for manipulation.

Usually the procedure lasts about half an hour and can be performed by various access methods: laparoscopy, mini or open laparotomy, hysteroscopy, colpotomy. Anesthesia is mainly used general, epidural is acceptable. In some cases, it is possible to use local anesthesia (when installing tubal implants).

Laparoscopy

It is considered the main technique for tubal ligation. Through small holes in the abdominal wall, surgical instruments (Veresh needle, trocar, etc.) are inserted, while the cavity is filled with gas for better visualization and access to organs. The uterus and cervix are fixed with special single-prong forceps and a manipulator.

Then, using the methods described above, the doctor forms an artificial obstruction of the fallopian tubes (coagulation, the use of brackets, clamps, etc.). When using clamps, they are applied to the isthmus of the tube (1-2 centimeters from the uterus). The rings are placed at a distance of 3 centimeters from the uterus, electrocoagulation is performed on the middle segment in order to avoid trauma to other organs. After the operation is completed, the laparoscopic instruments are removed and the wound is sutured.

The procedure is low-traumatic, characterized by a short rehabilitation period, the absence of pronounced skin defects (scars, scars).

Minilaparotomy

It is an alternative to laparoscopic surgery. A small incision (3-5 centimeters) is made above the pubic symphysis, through which obstruction of the tubes is formed by various methods. It is usually carried out after childbirth, it is not recommended to use the technique with a pronounced degree of obesity, myoma, adhesive process.

Suprapubic laparotomy is performed after complete involution of the uterus after delivery (after 4 weeks). With this technique, the Pomeroy or Pritchard method is used, Filshi clamps, rings, spring clamps are used. The Irving method is inappropriate due to the lack of necessary access to the fallopian tubes.

Laparotomy

In this case, an open ligation of the fallopian tubes is performed by dissecting tissues in the abdomen. It is carried out during caesarean section, as well as in the presence of endometriosis, inflammation in the pelvis. The latter contributes to the formation of scar tissue, which causes difficulties in performing the operation in a different way.

In the case of a joint decision of the doctor and the woman to perform surgical sterilization during caesarean section, the patient signs a written consent before the intervention.

Hysteroscopy

This technique is used quite rarely, most hysteroscopic methods are in the experimental stage. A significant number of unsatisfactory results of the operation associated with complications were noted. This surgical intervention is quite expensive and requires high professionalism of the doctor. At the same time, the effectiveness of the technique is inferior to other methods of tubal ligation.

For tubal occlusion, hysteroscopic equipment is exposed to the inner layer of the fallopian tube. Usually, a coagulation technique is used that causes thermal damage to the mucosal tissue. The positive aspects include the low invasiveness of the procedure, sterilization does not require dissection of the abdomen. Access is carried out vaginally into the uterine cavity, then directly to the tubes.

Colpotomy

Access to the tubes during the operation is made through the recto-uterine space. The surgeon makes an incision in the back wall of the vagina and penetrates the tissue between the vagina and the rectum. The fallopian tube is pulled out into the incision, bandaged, after which the wound is sutured.

The technique is distinguished by ease of implementation, availability, cost-effectiveness, and the absence of scars. The disadvantages of the procedure include the risk of infection, a long rehabilitation period (up to 1.5 months), during which sexual activity is contraindicated.

Rehabilitation

The length of the recovery period varies depending on the type of surgery. With laparoscopy, it is about a week, with colpotomy it lasts up to 1.5 months. During the rehabilitation period, it is necessary to follow all the instructions of the attending physician in order to avoid complications.

After the operation, small spotting and bleeding from the genital tract are possible for several days, which is due to the movement of the uterus during surgical procedures. After laparoscopy for 1-2 days, back pain, bloating due to gas filling of the abdominal cavity are characteristic.

After 1-2 days, it is permissible to take a shower, but you should not touch, heat, rub the operated area. During this period, constipation should be avoided. For 7-14 days, it is necessary to exclude weight lifting, physical stress, sexual activity (possibly longer).

When resuming sexual relations, the use of contraceptives is not required. After 2 weeks, you should visit a doctor to monitor the condition. The stitches are usually removed after 7-10 days.

After ligation of the fallopian tubes, there are no significant changes in the female body. This organ is used exclusively for sperm access to the egg and its transportation during fertilization into the uterine cavity. After the operation, cell fusion becomes impossible and fertilization does not occur.

The question arises, where does the egg go after tubal ligation. She dies, and this monthly process is natural for the body, since only a fertilized cell is able to move through the pipes. If conception does not occur, the egg dies 48 hours after ovulation and after a few days it dissolves without a trace in the abdominal cavity.

Since the process is natural and natural, it does not affect the recovery of a woman after surgery. The menstrual cycle passes with the same regularity, ovulatory functions are preserved, there are no hormonal disorders, and menopause is not accelerated.

Conducting surgical sterilization during caesarean section and after childbirth also does not affect the hormonal background, milk production, the general health and well-being of the woman.

Pain medications may be taken if pain or discomfort occurs in the operated area. In this case, aspirin is not recommended because of the possible increase in bleeding. During breastfeeding, the use of drugs should be agreed with the doctor in order to avoid their negative impact on the health of the child.

After the completion of the rehabilitation period, a woman is recommended to visit a gynecologist twice a year for preventive purposes.

Consequences and possible complications

Surgical sterilization surgery is generally well tolerated by patients and, when properly managed, complications are minimal (less than 2%). However, the invasiveness of the techniques does not exclude the possibility of the following negative consequences.

During surgical procedures - bleeding, damage to large vessels, mesosalpinx (mesosalpinx (mesentery of the fallopian tube), intestines (manipulation with a Veress needle, trocar), surrounding tissues (during coagulation), perforation of the uterus, complications during anesthesia, including allergic reactions.
Formation of a septic infection.
The development of the inflammatory process in the pelvic organs.
Pregnancy. In world gynecological practice, there have been isolated cases of conception after tubal ligation. However, at the first signs of pregnancy, it is necessary to consult a doctor, since in most cases it is ectopic.
Ectopic pregnancy. Occurs when the technique of manipulation is violated. About half of the cases are due to the electrocoagulation method of occlusion of the fallopian tubes. The condition requires emergency surgical intervention, therefore, at the first signs of pathology, it is necessary to seek medical help.
Some change in the menstrual cycle after the operation is acceptable. However, reliable information on the significant effect of tubal ligation on the cyclical processes in the female body has not been established.
Mental disorders, depression. In some situations, it becomes psychologically difficult for women to make a decision about sterilization, especially if there are medical indications for the procedure.
Quite often, women regret the sterilization performed and wish to regain their reproductive ability (fertility). Often this is due to a change in life circumstances (new marriage, death of a child, etc.). In gynecological practice, plastic surgery techniques have been developed to restore patency, but their success depends on the method of sterilization performed. For example, after ligation of the fallopian tubes according to Kocher (more precisely, the imposition of Kocher clamps), recovery is possible if the fallopian tube remains intact. If it was excised, the probability of successful plasty depends on the size of the lost segment. The larger it is, the lower the probability of a successful recovery. It is not advisable to perform the operation if the length of the fallopian tube is less than 4 centimeters. Operations to restore fertility are considered complex, expensive and do not guarantee success even with a highly qualified and experienced surgeon. If plastic is considered unsuccessful, or conception does not occur, it is advisable to do IVF after tubal ligation. According to statistics, the effectiveness of the procedure is 30%.
This birth control method does not protect against sexually transmitted infections. Therefore, when insecure in a partner, it is necessary to use barrier methods of contraception.

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

There are different methods of 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.

The dressing 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 give up excessive physical exertion for a week, a 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 there is 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.

Tubal ligation is one of the events that we cannot change. So it must change us...

A 35-year-old woman came to me for a consultation complaining of a complete loss of libido and a conflict with her husband.

She has three sons and three C-sections behind her. During the latter, they did a tubal ligation, convincing her that this was a necessity.

The doctor told her that the uterus can no longer give birth, and there are varicose veins in the pelvis, and in general the procedure is safe and does not affect anything. In addition, it is the best method of contraception. It is environmentally friendly, modern, guaranteed, safe.

What is tubal ligation

The fallopian tubes are tied up, as a rule, with resection (removal) of a part of the tube. A clip can be applied to the pipe, it can be burned, there are different ways.

But the essence is the same - the fallopian tubes become impassable, and pregnancy is impossible. This procedure is performed under anesthesia, most often laparoscopically.

Tubal ligation is done both for medical reasons and at the request of the woman herself, who no longer plans to give birth.

As a rule, this is done after 35 years, when there are children, or some contraindications for the birth of children - serious illnesses, the possibility of hereditary diseases in a child, and so on.

At first glance, it seems that the procedure is safe, as sparing as possible. In a word, why not tie the tubes? There will be no hassle with contraception, no need to poison yourself with hormones, once and ready, what could be better?

Life with your tubes tied

Let's return to the heroine of our story. After the operation, it turned out that she began to have health problems - uterine bleeding, cycle disorders, lack of ovulation.

There were depressions, emotional breakdowns, resentment and, of course, the loss of sexual desire.

Where does the loss of libido come from after tubal ligation?

As soon as the woman's tubes were tied, that is, they sterilized her, the following happens. The psyche gives an order to the body that the reproductive system is no longer needed, the reproductive function can be completed. This is how our subconscious works.

This process is similar to what happens in old age. When aging occurs, the reproductive system is turned off first - as unnecessary.

A woman remains young in appearance and in years, but the body begins to gradually fade away. The body understands the command literally - there will be no more children, which means that all systems associated with childbearing are not needed.

For our body, for the subconscious, there is a simple logic - why have sex if there are no more children? The disappearance of sexual desire in such a context is "natural", quite predictable.

As a result, after the tubal ligation, our heroine's desire disappeared, and of course quarrels with her husband began, tension in the family, conflicts.

As a rule, after tubal ligation, changes in the health and character of a woman appear and grow imperceptibly.

Her cycle is broken, hyperplastic processes can develop - endometrial hyperplasia, polyps, fibroids, endometriosis, mastopathy, breast fibroadenomatosis. What is happening, the woman does not associate with the fact that she tied the pipes.

Few women understand that, despite the simplicity and obviousness of the procedure, behind this is a mechanism for the destruction of fertility, the very possibility of creating a new life.

The character of a woman changes

If the femininity is no longer in demand, then masculine behavioral strategies will increase in the woman's character, and the influence of social values and internal exhaustion from this will also grow.

She can begin to compete with a man, to suppress her son, not to give life to her daughter. So many devastating changes, it would seem, why, from a simple tubal ligation. I don't even believe that this could be.

Such "subtle matters" are never explained to a woman, and it is unlikely that a doctor thinks about the long-term consequences of tubal ligation.

My female life is over

The subconscious understanding that "never again", "I will not give birth again", triggers irreversible changes in the body, leading to aging and exhaustion of the reproductive system.

And vice versa, even in extreme old age, if a woman creates something, "gives birth", creates, does something with pleasure, then her reproductive system fades away slowly and for many years she will maintain health, good spirits, a positive attitude to life.

Therefore, at any age, especially at an older age, creativity, the creation of a new one, the fullness and happiness of life, the realization of one's goals are extremely important. And, of course, a satisfying intimate life.

It is highly undesirable in life to do something that is irreversible

For example, ligate pipes.

Abortion, someone's ruined life is one of the clearest examples of the irreversibility of what has been done. No matter how much a woman experiences later, this life cannot be returned.

If an irreversible event has occurred, then we have a choice.

First, we can go into hopelessness and depression, which can destroy us, deprive us of the future, make us lay down our hands and literally die.
And secondly, we can learn to live our helplessness, impotence and pain, and thereby launch the mechanism of transformation and change.

I knew a woman who had seven abortions. When she realized the irreparability of what had happened, she took and adopted seven children. It was not easy for her, but when I saw her a few years later, she was happy.

How to live your helplessness

We face our own impotence, weakness and hopelessness on various topics several times a day. Different circumstances of life can make us give up.

Tubal ligation is one of the events that we cannot change. So it must change us.

Tune in to your impotence, grief, fear, stress, pain. But ONLY through the sensations of the body. Walk mentally over the body - neck, shoulders, arms, chest, back, stomach, legs. Feel the POWERFULNESS OF THE BODY. Feel crushed PHYSICALLY, helpless and smeared with a thin layer on the ground.

Surrender to this impotence, stop fighting. Surrender with your whole body, look at what is happening from the side. The body went limp, spread like a burning candle.

If you do it right, then you rest, the body and soul are healed, renewal and new strength come to life.

Tubal ligation is an event that will forever deprive you of a thoughtless attitude towards life and death, which will force you to change, every day a little, constantly and for the rest of your life.

Or, if you make a different choice, don't change. But then get old, get sick, get irritated and be unhappy.

The choice, as always, is yours. published .

Elena Volzhenina

If you have any questions, ask them

Tubal ligation is an effective contraceptive method that is irreversible. This technique is also called female sterilization. It is carried out only with the consent of the patient or for special medical reasons. Such sterilization is carried out surgically, often during a caesarean section. After tubal ligation for caesarean section, the consequences can be varied, as they depend on many factors such as the method of sterilization, surgical access, etc.

The attending gynecologist will answer all your questions

Sometimes a woman has such circumstances in her life that she does not want or absolutely cannot have children. Today, gynecologists can offer a lot of contraceptive methods. But if the patient is contraindicated in pregnancy for the rest of her life, then it is better to refuse lifelong use of hormonal contraceptives and undergo a surgical sterilization procedure.

This procedure is usually performed under anesthesia and is often combined with a caesarean section, which is very convenient and does not require additional incisions in the patient's abdominal wall to gain access to the fallopian tubes. All manipulations are carried out after the child is removed from the uterus, through the same incision. Tubal ligation, unlike other methods of contraception, gives the patient a 100% guarantee that pregnancy will never occur.

Such an operation, as already mentioned, is carried out only with the consent of a woman whose age is over 35 years old, and she already has 2 or more children. If there are medical indications, then the presence of children and age characteristics are no longer taken into account, although the written consent of the patient is also necessary. DHS (or voluntary surgical sterilization) has a number of indications and contraindications, which are also taken into account when deciding on an intervention.

Indications for holding

Before agreeing to such a procedure, a woman needs to undergo a consultation, during which the patient is explained all the details of the intervention, the consequences and indications. The girl must receive objective information in order to make a choice, agreeing or refusing DHS. In addition, the available indications for such an intervention are explained.

The patient is completely and unconditionally sure that she does not want to have children ever in her life;
If a woman already has a child, and her age has exceeded 35 years;
With dangerous cardiovascular pathologies, pulmonary hypertension, active hepatitis forms, etc.;
The presence of pathologies that can negatively affect the process of gestation or somehow aggravate the pregnancy;
If the first three births occurred with the help of a surgical delivery operation (caesarean section);
If a woman has a severe hereditary disease that can pass to children;
With liver failure, leukemia or diabetes;
The patient has no pathologies that can act as an obstacle to DHS.

Many patients mistakenly believe that the caesarean section and further tubal ligation are two interrelated surgical procedures, but this is not true. Even if during the caesarean section it turned out that it is dangerous for the patient to become pregnant and give birth to offspring in the future, doctors cannot perform sterilization without the consent of the woman. Possible risks are determined even during preoperative preparation, it is then that the issue of DHS is discussed with the patient. If the woman agrees, she gives written permission for the dressing to be performed.

Contraindications

There are a number of certain conditions in which voluntary surgical sterilization is contraindicated. Such conditions include obesity and allergic intolerance to drugs used for anesthesia, oncological pathologies, malignant neoplasms. If a woman is under 35 years of age or in the presence of adhesive or inflammatory processes in the genitourinary and reproductive structures, DCS is also contraindicated.

Bandaging is not performed for patients who are single, do not have a single child, or women with unstable sexual and family relationships. After all, circumstances can always change, then a woman wants to give birth, but she can no longer, because the sterilization procedure is irreversible, and a bandaged canal in both tubes makes pregnancy impossible. Therefore, doctors strongly recommend such women not to rush, and to choose for contraception not such a cardinal, but a safer and reversible method.

Advantages, disadvantages

The fallopian tubes carry out a transport function for sperm and eggs. The female germ cell matures and is sent through the fallopian tube to the uterine cavity, where it is fertilized with sperm, after which it is implanted all through the same tube into the cavity of the uterine body, where it is implanted into the wall of the organ. The main purpose of a fallopian tube ligation is to exclude the possibility of an egg meeting with male germ cells, as a result of which pregnancy becomes impossible.

Although surgical sterilization belongs to the category of irreversible operations, in isolated cases, self-healing of the patency of the fallopian tubes occurred. Most often, such processes occurred due to non-compliance with the DHS technique or incorrect selection of the surgical approach technique. But in general, the restoration of the tube after ligation is possible only with the help of plastic surgery, which is not always successful, expensive and technically complex.

Therefore, if the patient urgently wants to give birth after surgical sterilization, doctors can offer her in vitro fertilization. But this method is also very costly in financial terms and does not always provide the desired result. That is why you need to think a thousand and once, weigh all the factors, and only then decide on such a crucial step. After all, it is almost impossible to have a child after DHS. The dressing procedure is not without its drawbacks and advantages.

Firstly, after such an intervention, the guarantee of contraception is 100 percent, and there is no chance of conception.
Secondly, such sterilization can be performed after a caesarean section, which is very convenient and does not require additional preparation of the patient for surgery.
Thirdly, such an intervention does not affect the woman's sexual desire in any way, does not affect her general health and does not violate the patient's hormonal background.

The disadvantages of DHS include the irreversible lack of fertility, the need for anesthesia during dressing, and the existing likelihood of an ectopic with insufficient qualifications of the doctor who performed the sterilization. In addition, this procedure is a surgical intervention, therefore, it can have characteristic complications and consequences such as inflammation, bleeding, etc.

Dressing methods

A healthy and desirable baby is the dream of every woman.

Usually, dressing is performed after caesarean by laparotomy through an incision made to remove the child. Although, if the patient wishes, the dressing can be carried out in a more gentle way - laparoscopically, when all manipulations are carried out through two punctures in the abdominal wall. The procedure for tying the fallopian tubes can be carried out by various methods, among which the most popular are: cauterization, ligation followed by an incision, ligation with a silk ligature, applying a clip or installing a special implant inside the tubal canal.

Today, silk ligatures are used to tie pipes quite rarely, usually this is done by highly qualified specialists with impressive experience. But the rest of the methods are quite popular and are used almost everywhere. For example, the imposition of a special clip on the pipe (occlusion or blocking) is sometimes referred to as reversible operations, because they can be removed over time. After the clip is removed from the tube, self-healing occurs, which makes pregnancy quite possible in the future. Coagulation involves sealing the tubal canal about 3 cm from the uterine body using electrosurgical instruments or a laser.

Relatively young, new methods include implantation into the tube of implants (blockage). Such sterilization is carried out using a hysteroscopic technique and under mandatory ultrasound control. Through the cervical canal, special devices are introduced into the uterus, and then into the tubes, which do not allow sperm to move into the tube. Within a few months (usually 3-4) there is a complete overgrowth of the fallopian lumen. During this period, the woman will still have to protect herself, because the possibility of pregnancy remains. After 4 months, the patient undergoes a control hysteroscopy, which shows the degree of overgrowth of the fallopian tubes. If they are completely impassable, then the sterilization operation is considered viable.

After operation

Before the intervention, the patient undergoes standard preoperative preparatory measures with the delivery of laboratory tests and other studies.

About a week before the caesarean and dressing, the patient should stop taking all medications.
Do not eat or drink before the intervention.
After surgical sterilization, any physical activity is strictly prohibited, you can not drive and wet the wound.
In general, contraindications after ligation surgery are similar to those after caesarean section.
If the intervention was carried out as an independent laparoscopic procedure, then it is necessary to avoid stress, the bath is also strictly prohibited, but you can go to the shower after closing the wound from water in advance.
Sexual rest is also necessary, the doctor will determine its exact terms individually.
From the vagina in the first day or three, a bloody mass may stand out.
Sometimes constipation may occur in the early days, which doctors recommend avoiding with a special diet.

After the resumption of sexual activity, the need to use contraception disappears.

Consequences and complications

If the doctor is sufficiently qualified, and during the surgical sterilization all the necessary standards were observed, then no negative complications should be expected. If the operation was performed poorly, then there is a possibility of serious complications and severe consequences such as sepsis, vascular damage, bleeding, inflammatory damage or allergic reactions against the background of the anesthesia used.

After the dressing, the woman is forever deprived of the opportunity to have children, but the patient does not experience any hormonal problems as a result of the operation, as well as menstrual disorders.

The effectiveness of this contraception

If we compare the procedure of surgical ligation of the fallopian tubes with other methods of contraception, then it is considered the most effective. But in isolated cases, pregnancy is still possible if during the intervention there was an incomplete overlap of the tubal lumen due to medical error.

The probability of failure of surgical sterilization is negligible. But when deciding on such contraception, a woman must definitely take into account that in the future she will never be able to become pregnant. Therefore, if at least one doubt remains about DHS, then it is better to abandon this method of contraception, replacing it with a less cardinal one.

Blocking the fallopian canals does not affect the ovulatory functions and the patient's menstrual cycles. In other words, the egg will also continue to mature monthly, and menstrual bleeding will also come with each cycle. At a certain time, a woman will enter the menopausal period, as if no operations on the reproductive organs were ever performed.

Before agreeing to such an important and desperate step, the patient needs to think very carefully, weigh all the arguments. According to statistics, more than half of the patients who agreed to surgical sterilization later regretted their decision, but they could not return their childbearing and reproductive functions back.

Consequences of tubal ligation: sepsis, vascular ruptures, bleeding, anaphylactic shock from anesthesia during surgery, inflammatory processes, a small percentage of unwanted pregnancies (6 out of 1000 women still "fly" after tubal ligation).

Features of tubal ligation in women

Tubal ligation in a woman is considered one of the reliable ways to prevent unwanted pregnancy. This is a kind of sterilization method, which is performed through surgical intervention. If done correctly, tubal ligation will forever eliminate the possibility of pregnancy. Tubal ligation is recommended in certain situations. So, this procedure is relevant when a woman cannot bear a child safely for her health. Also, this method of irreversible contraception is used if there are contraindications in the use of oral agents, spirals. Very often, tubal ligation is done by women when they voluntarily refuse to have children.

The purpose of this method of contraception is to achieve artificial obstruction of the fallopian tubes. As a result, the spermatozoa will not have any opportunity to meet the egg and then fertilize it.

"Female Sterilization" has its own legal implications. Thus, the obligatory legal agreement of the woman for this operation is necessary, the signing of a number of different documents. After a woman contacts a medical institution with her desire to have a tubal ligation, a certain time is allotted for reflection (to think carefully about her decision). When the allotted time passes and the woman agrees to the operation, she will need to sign an official document - an agreement. Such documents are legally binding.

Tubal ligation methods

There are several ways to ligate the fallopian tubes. Can do: bandaging and circumcision; tying or imposing special staples; cutting and cauterization.

There are such types of surgery:

- laparoscopy, aparotomy (surgery of the abdominal cavity);
– endoscopy of the uterus with subsequent application of special plastic micro-tampons;
- colpotomy (the so-called vaginal method).

All these operations are performed under anesthesia. They are not very long in duration - about half an hour. A few days after the operation, the patient is already discharged home. Experts assure that the risk of complications after these operations is minimal. And only in quite rare cases, there may be some side effects. We will deal with this issue in more detail.

Side effects after tubal ligation in women

Whatever doctors say about the minimal risks of side effects and consequences of tubal ligation, in practice, many people face various problems. Those who have undergone such an operation say that immediately after it there may be severe weakness and even temporary pain. There is also the possibility of dizziness, cramps (which resemble period pains), and bloating. Often there is nausea. All this can be attributed to the side effects of the reaction of the female body to anesthesia and surgery.

After the tubal ligation is normal in the body of women, there are no special changes. At the same time, weight is not gained, if we compare this method of contraception with hormonal contraceptives. The libido (sexual desire) of a woman also remains normal. As for hormonal changes, they do not occur. And all due to the fact that female hormones, as before, are produced by the fair sex. Also, after the operation, the menstrual cycle is not disturbed. It basically stays the same as it was before. If a woman decides to ligate the fallopian tubes, then she must clearly understand that she will no longer be able to have children. This method of protection is considered irreversible.

Consequences of tubal ligation in women

No matter how sad it may sound, sometimes tubal ligation operations are not very successful. Some stages of the operation may be incorrectly or poorly performed. Because of this, women can be very dire consequences. For example, sepsis may develop. The integrity of the blood vessels (rupture of the vessels) may also be compromised. Sometimes, after a tubal ligation, a woman suddenly starts bleeding. It is also not necessary to exclude the possibility that an anaphylactic shock can occur in a woman from anesthesia. The consequences of tubal ligation operations include the possibility of developing various inflammatory processes. If the tubal ligation was done incorrectly, then the woman will be able to become pregnant.

According to statistics, after this procedure, 6 out of 1000 women still "fly".

As you can see, all these listed consequences are very serious in themselves. And some women after a tubal ligation operation suffer a whole “bouquet” of such consequences. It is believed that tubal ligation is fundamentally different from other methods of contraception: after this procedure, the reproductive function of a woman is completely and forever eliminated. But in world practice there are women who gave birth to children even after tubal ligation. Of course, the percentage of such women is very small. It is almost impossible to get into his number. Therefore, this fact must always be remembered. It is not difficult to perform the operation, but it can be very difficult to deal with the consequences.

In order not to face disastrous consequences after a tubal ligation operation, it is recommended to carefully plan this procedure, find out the necessary information, compare reviews, take into account the reputation of the clinic, the experience of certain doctors. It is best to perform such an operation in stationary clinics. You should also unconditionally follow all the recommendations of doctors regarding the rehabilitation period.

Reviews of tubal ligation

Statistics is one thing. But what women say after tubal ligation surgery is much more interesting. There are a lot of reviews. Of course, there are a huge number of women in the world who were satisfied with the chosen tubal ligation procedure. They speak well of this operation, as they no longer need to worry about whether an unplanned pregnancy will occur. Their head no longer hurts about how to protect themselves. Some point out that their husbands are now very happy, as they no longer need to use additional protection in the form. After all, as you know, almost no one likes sex with a condom.

Someone speaks in favor of a tubal ligation operation, since after it, the libido remains in order. Not everyone can boast of this fact while taking oral contraceptives. As you know, hormones greatly reduce libido. After the operation, there are no problems with desire in women. Among the reviews you can also find those in which women praise the operation precisely because of the material aspect. In the future, they no longer need to spend extra money on contraceptives, which in our time are not very cheap.

Among the reviews about tubal ligation, you can find a lot of negativity. Many say that this is still a surgical intervention, which has a high risk of postoperative complications. Someone after the operation had heavy bleeding, someone had adhesions, someone had sepsis. Some even managed to get pregnant and give birth to an unplanned child. As you can see, there are a lot of reviews: both bad and good.

We are found:

Can I lose my desire to have sex after a tubal ligation?