Surgery

Tubal Ligation

search

Tubal Ligation, Tubal Sterilization

  • Indications
  1. Permanent Contraception
  • Advantages
  1. Highly effective permanent Contraception
  2. Decreased risk of Pelvic Inflammatory Disease
  3. Decreased risk of Ovarian Cancer
  • Disadvantages
  1. Surgical risk
  2. Ectopic Pregnancy risk (one third of pregnancies)
  3. No protection against Sexually Transmitted Disease
  4. Regret following sterilization (<10% undergo reversal)
    1. Reversal success rate : 47-90%
  5. Functional Ovarian Cyst risk increases (Odds Ratio 1.7)
    1. Holt (2003) Obstet Gynecol 102:252-8 [PubMed]
  • Efficacy
  • Failure rate
  1. First year failure rate: 0.5%
  2. Overall cummulative 10 year failure rate: 1.85%
    1. Peterson (1996) Am J Obstet Gynecol 174:1161-70 [PubMed]
  3. Minilaparotomy 10 year cummulative failure rate: 2.01%
  4. Filshie clip 10 year cummulative failure rate: 0.5%
    1. Small study (n=200)
    2. Filshie (1998) ISGE 7th annual meeting, South Africa
  • Complications
  • Acute short-term
  1. Overall rates
    1. Mortality: 1-2 per 100,000
    2. Major complications: <0.5% of procedures
  2. Trauma to contiguous organs (e.g. Bladder, bowel)
  3. Hemorrhage
  4. Anesthesia complications
  • References
  1. Baill (2003) Am Fam Physician 67(6):1287-1302 [PubMed]
  2. Pati (2000) Obstet Gynecol Clin North Am 27:859-99 [PubMed]