What Should I Expect If I Get a Tubal Ligation Procedure?

In This Section

• Sterilization

• How effective is sterilization?

• How safe is sterilization?

• What can I expect if I get a sterilization procedure?

• How do I get a sterilization?

• What are the benefits of sterilization?

• What are the disadvantages of sterilization?

Tubal ligation is a surgical procedure. The doctor cuts or blocks your fallopian tubes through a cut in your skin on your belly. You’ll get medicine to help with pain, and you can usually go home the same day.

How does tubal ligation feel?

Your doctor will help make your procedure as comfortable as possible. You’ll get general anesthesia, so you’ll sleep through the procedure — you won’t feel or remember anything. After the surgery, you may have pain for a little while from the procedure itself and/or from the gas that was pumped into your belly. But most people recover within a couple of days.

What happens during a sterilization procedure?

There are different kinds of sterilization. With a tubal ligation, the doctor will either block or remove small sections of your fallopian tubes. With a bilateral salpingectomy, the doctor will remove your tubes completely. There are a few different ways to do sterilization procedures.

Laparoscopy is the most common procedure. You’ll get general anesthesia to put you to sleep. The doctor pumps gas into your belly so they can see your organs. They make a few small cuts in your lower belly and use a laparoscope (a tool with a light and a lens) to find your fallopian tubes. Then they use heat, clips, or rings to close off your tubes or remove them completely. The whole thing takes about 20-30 minutes, and you can usually go home the same day. There’s very little scarring.

Another common procedure is a minilaparotomy. It’s often done right after childbirth. You get local anesthesia and your doctor makes a small cut near your belly button. The doctor brings your fallopian tubes up through the cut, then removes a short section of your tubes, blocks your tubes with clips, or removes the tubes completely. It usually only takes a few days to recover.

How will I feel after sterilization?

You may have:

• Tiredness or dizziness soon after waking up as the anesthesia is wearing off
• Nausea
• Mild pain in your belly or where your skin was cut
• Cramps
• Vaginal discharge or bleeding
• Neck or shoulder pain (from the gas)

Most symptoms only last a short time. But call your doctor right away if you have:

• A rash, swelling or trouble breathing
• A fever of 100.4°F or higher
• Severe, continuous pain in your belly that keeps getting worse or doesn’t get better with pain medicine
• Unusual discharge or odor from your vagina
• Dizziness or fainting spells
• Pus, drainage, bleeding, redness, or swelling where any incision (cut) was made in your skin
• Vomiting or nausea that doesn’t stop
• Symptoms of pregnancy

How long will it take me to recover after my sterilization?

Your recovery depends on your general health and how your body reacts to surgical procedures.

You can usually recover from sterilization within a couple of days, but it’s a good idea to take it easy until you feel better. Avoid lifting anything heavier than 12 pounds for a week after the surgery if you can.

If you have stitches, they’ll either dissolve on their own or your doctor will have to take them out later. Your doctor will let you know if you need to come back to get your stitches removed.

How soon can I have sex after sterilization?

Talk with your doctor about when it’s safe to start having sex again. Sterilization starts preventing pregnancy right away, but wait until you feel healed and ready to have sex.

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Sterilization

• 99% effective

• Costs up to $6,000, but can be $0

• Surgical procedure

• Do it once, lasts forever

Sterilization doesn’t protect you from STDs. Use a condom to help stop STDs.

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Tubal Ligation Surgery, Risks, Side Effects & Reversal

Tubal Ligation is a surgical procedure that permanently prevents pregnancy. It is also casually known as “getting your tubes tied,” and involves the cutting or blocking off of the fallopian tubes.  This stops the egg from traveling from the ovary to the uterus so fertilization and implantation cannot occur.

The Tubal Ligation Procedure  

Tubal ligation is a relatively simple surgery. It can be done at any time, including immediately after giving birth, and many women prefer to have it done as part of a Cesarean section procedure.

During a standard tubal ligation, either general anesthesia or a spinal block is administered. If the operation is not part of a C-section, the surgeon makes two small abdominal incisions and inserts a small camera mounted on the end of a tube called a laparoscope. The abdomen is then inflated with gas, allowing greater visibility and access. The surgeon will then cut or cauterize each of the fallopian tubes and clamp or tie them off.

Another form of tubal ligation is called a “hysteroscopic tubal occlusion procedure” and it requires no anesthesia and can be done in an outpatient clinic. A hysteroscopic tubal occlusion procedure is done via the cervix and involves inserting coils inside of the fallopian tubes instead of cutting or cauterizing them.    

Post-Op Recovery After Tubal Ligation

After a tubal ligation, women can usually go home on the same day as the surgery. However, the effects of the anesthesia will require a family member or friend to help with driving and getting the patient settled at home.

In the days following the tubal ligation, it is very important to allow the body time to heal. There is often some localized abdominal pain around the incisions for which a doctor may prescribe painkillers, and some women may experience cramping, dizziness, fatigue, bloating, gassiness or shoulder pain.

Women should contact their doctor if they have a temperature of 100.4° F or greater, if they experience pain and/or bleeding or discharge from the incision site that continues or increases 12 hours after the operation, or if they have fainting spells.

Women can expect to resume to normal activities almost immediately after the surgery unless there are other factors such as needing to recover after Cesarean section, but if the tubal ligation is done in conjunction with giving birth, it should not add to the length of hospital stay. Heavy lifting and sexual intercourse should be delayed for two to three weeks after the surgery to ensure a full recovery.

If the tubes have been tied using the laparoscopic method, there is no need for further tests to ensure efficacy and women can end other forms of birth control immediately. However, if the tubes were tied via a hysteroscopic tubal occlusion, women should continue using contraceptives for three months.  After three months a test called hysterosalpingogram will confirm the surgery was effective.

Benefits and Risks of Tubal Ligation

Tubal ligation is a common, low-risk surgery that provides permanent birth control. For women who are sure they want to prevent any future pregnancies, it is approximately 95 to 99 percent effective, although rates vary according to the type of surgery performed. Tubal ligation also has the additional benefit of lowering the risk of ovarian cancer. For that reason, some women with a history of ovarian cancer may opt to have their tubes tied as a preventive measure against the disease.

Tubal ligation is not recommended for women who are not absolutely positive they want to prevent the future pregnancies. In some cases, reversing the procedure is possible, but it is expensive and rates of conception are often decreased and In Vitro Fertilization (IVF) may be necessary. There is also a slight increase of ectopic pregnancies after a tubal ligation and the procedure does not protect against sexually transmitted disease (STDs).

Tubal ligation is not an appropriate form of sterilization for everyone. Women who have had previous abdominal surgeries, diabetes, or are obese tend to have a higher risk of complications related to getting their tubes tied. Women should discuss their options with the doctor to decide if the surgery is right for them.

A relatively rare but serious complication of tubal ligation is a condition called Post Tubal Ligation Syndrome (PTLS). PTLS occurs when the blood supply to the ovaries is damaged during the operation to tie the tubes. The result of PTLS is a significant decrease in the production of the hormones estrogen and progesterone. This can have lasting health effects, including symptoms similar to those of menopause. Women in their 20s appear to be at a higher risk for PTLS than women who have tubal ligations in their 30s and 40s.

Side Effects of Tubal Ligation

Many women may worry about side effects after tubal ligation. Generally, these are rare or have been shown to be related to issues other than the surgery.

Unplanned and Ectopic Pregnancies

Pregnancy, or failure of the tubal ligation, is one potential unwanted side effect of the procedure. Women who have had their tubes tied are slightly more likely to have ectopic, or tubal, pregnancies than other women. The U.S. Centers for Disease Control and Prevention studies show approximately one in 200 women will experience pregnancy after having their tubes tied. Of these, less than seven out of 1,000 of the pregnancies will be ectopic, but that number is still higher than the rate of ectopic pregnancies among non-sterilized women. Research conducted over an eight to 14-year period by the U.S. Collaborative Review of Sterilization and published in 2015 showed pregnancy happened in only 143 of the 10,685 (1.33%) women studied.  Women who were under age 30 when they had the procedure had a higher failure rate.

Post-Tubal Ligation Syndrome (PTLS)

Post-Tubal Ligation Syndrome (PTLS) is a cluster of symptoms reported which include heavy or missing menstrual periods, hormonal problems, or problems that may mimic menopause. Its existence remains controversial among doctors and researchers.   Women reporting PTLS list side effects such as hot flashes, heavy periods, mood swings, anxiety, depression, sleep problems, fatigue, mental “fog” or confusion, and vaginal dryness, among others.

Some doctors feel that a loss of blood flow to the severed fallopian tubes is to blame, while others suggest women who were using birth control pills prior to surgery may be more likely to experience PTLS. They experience symptoms from stopping the contraception, rather than the result of the surgical procedure. Dr. Stephen L. Corson, professor at Thomas Jefferson University and Women’s Institute in Philadelphia, conducted a study comparing hormone levels in women who had tubal ligations versus those who had not had the surgery. He found no significant differences in the hormone levels of the groups, indicating no damage to the ovaries from tubal ligation surgery. Other studies, including one by the American Society for Reproductive Medicine, also failed to support the existence of PTLS.

Future Hysterectomy

Another side effect that may concern women is the reported connection between tubal ligation and the risk of future hysterectomy. Clinical studies published in the Journal of Obstetrics and Gynecology show a statistically small increase in hysterectomies in sterilized women in the U.S. The researchers hypothesized this was due to the sterilized women’s lower threshold for being willing to undergo a hysterectomy rather than the presence of other factors. American Family Physician points out that hysterectomy rates are higher in the U.S. than in the rest of the world. They state, “For women who were sterilized before the age of 30, a plausible biologic effect of sterilization on hysterectomy risk is unlikely.” Findings from studies in other countries do not report the same increased risk for hysterectomy after tubal ligation as that seen in the U.S.  

Ovarian or Breast Cancer?

Women considering tubal ligation may worry about increasing their risk for ovarian cancer or breast cancer, or an increased risk for other diseases. However, the Collaborative Review actually saw a reduction in rates of ovarian cancer in patients who had tubal ligation surgery both in the U.S. and in other countries, and they found no relationship between breast cancer and tubal ligation. The rates for pelvic inflammatory disease also decreased in women who had their tubes tied. When P.I.D. abscesses do occur, fewer sterilized patients required hospitalization for treatment than did their un-sterilized counterparts.

Regretting the Decision

Regret is perhaps the side effect of tubal ligation most discussed among women and their doctors before surgery. Common factors associated with regret, according to the report in American Family Physician, include a young patient and unpredictable life events. Pressure from spouses, doctors, relatives, and others also influence whether a woman feels regret about her decision to seek permanent birth control through tubal ligation.

Tubal Ligation vs.  Vasectomy

The male equivalent of a tubal ligation is a vasectomy. In a vasectomy, the vas deferens is severed and prevents the release of sperm. Like a tubal ligation, a vasectomy is a permanent form of sterilization. A vasectomy is a safe medical procedure with a recovery period of only a few days. It is 99 percent effective in preventing pregnancies, and has no sexual side effects. Like a tubal ligation, though, it does not protect against STDs.

In the Unites States, tubal ligation is more common than vasectomy; however, vasectomies are usually cheaper than tubal ligations and have even fewer associated complications.

People who are in a committed relationship and are sure they do not want to have children in the future should consider the pros and cons of getting a tubal ligation or a vasectomy. The risks for each person and their personal medical history should be carefully considered.

Choosing Tubal Ligation

Choosing to have a tubal ligation is a personal decision that should be considered carefully. For women who are sure they do not want to have children in the future and want to have full control of their reproductive health, getting their tubes tied is a safe and effective option.

If you have any questions about whether a tubal ligation procedure is right for you, please contact Kansas City ObGyn today at This email address is being protected from spambots. You need JavaScript enabled to view it. or 913-948-9636.

Canalicular (nasolacrimal) test at a price of 2100 rubles in Moscow, Yuzhny clinic

Pathological processes occurring in the lacrimal ducts are a fairly common phenomenon in infants. This is due to the fact that during the development of the fetus in the womb, a thin membrane closes the nasolacrimal canals. Normally, this membrane should be torn as soon as the newborn makes its first cry, or within the first couple of weeks of life. In cases where the membrane remains intact, it prevents the normal outflow of tear fluid, which over time provokes the development of diseases such as conjunctivitis or obstruction of the nasolacrimal canal.

Modern medicine uses a method called the “tubular test” (tear-nasal or West test) as a tool for assessing the patency of the nasolacrimal ducts. This method of functional assessment is recognized as absolutely safe, and therefore it is prescribed not only for adult patients, but also for children. Based on the results obtained, the specialist is able to select a differential therapy that will effectively eliminate the stagnation of the lacrimal fluid and lacrimation.

In Moscow, a tear-nasal test is performed by competent specialists at the Yuzhny Medical Center. Carried out in the clinic in strict accordance with all the rules established by the International Association of Ophthalmologists, the procedure provides results that the ophthalmologist uses as a basis for determining further actions (additional diagnostics, appointment of adequate treatment, etc.).

How it is done

To conduct a tubular test, the patient is located on a couch or chair in the “sitting” position. The doctor, using a pipette, instills a drop of dye into the conjunctival cavity. The latter is a 3% solution of collargol or a 1% solution of sodium fluoroscein. After the introduction of the solution, the patient should slightly tilt his head forward and blink for a few seconds.

After three to five minutes, he takes a napkin and blows the contents of each nostril into it separately. In some cases, the introduction of a bellied probe under the lower nasal concha takes place. In this case, this tool should be wrapped with a bandage or cotton wool soaked in water. The results of the tubular test are interpreted by a specialist based on the presence of traces of the coloring solution on the probe or napkin.

Indications for nasal tear test

The need to assess the condition of the lacrimal ducts may arise for patients – both adults and children, including newborns. The indications for a lacrimal patency test, which will provide relevant information, are the following conditions:

1. Tearing when the person is not crying.
2. Reddened or swollen conjunctiva.
3. Continuous tear in the eye.
4. Presence of discharge of pus from the eyeball.
5. Swelling of the zone of the inner corner of the organ of vision.

Lacrimal patency tests are also prescribed as part of a comprehensive ophthalmological examination. They can act as a component of a preventive examination of the nasolacrimal ducts.

Contraindications

The list of contraindications, in the presence of which a tubular test is impossible, includes only one item – individual intolerance to the components of the dye used during the procedure. Due to the fact that neither fluorescein nor collargol have cross-allergy, it is possible to replace one of them with the other if the patient has an allergic reaction to a particular dye.

Results

The results obtained during the procedure are to be evaluated in one of the following ways:

1. Examination of the contents obtained by blowing the patient from each nostril separately on a wet wipe.
2. The use of turunda, which is introduced into the left and right nasal passages alternately.
3. Using a bulbous probe inserted into the lower nasal passage.

Normally, a ring test, showing the ingress of a coloring solution into the nasal cavity no later than five minutes after its instillation, indicates the absence of pathologies. In this case, the specialist gives a positive assessment of the level of patency of the lacrimal ducts.

If the dye gets on the probe, turunda or napkin during a period of time ranging from 6 to 20 minutes, then we are talking about a slow process. Such results may indicate stenosis of any of the departments of the lacrimal ducts.

The ingress of a dye on a napkin or other material used in the course of diagnosis, later than 20 minutes after its instillation, or its absence in the nasal cavity, acts as evidence of a complete blockage of the nasolacrimal canals.

IDC – Irkutsk Diagnostic Center

Description of the service

Service code:

2Ж1050

Availability of results:

next business day, after 15:00 9000 3

Rehberg’s test makes it possible to judge the functional state of the glomerular and tubular apparatus of the kidneys by assessing the rate of glomerular filtration and tubular reabsorption. The test is based on the fact that creatinine is filtered only by the glomeruli, is practically not absorbed and is not secreted by the tubules. By determining the concentration of creatinine in blood and urine collected over a certain period of time (usually 24 or 12 hours), concentration indices are calculated by dividing the urine creatinine by the blood creatinine. Knowing the diuresis per minute, calculate the glomerular filtration CF according to the formula: CF = C x D, where C is the creatinine concentration index, D is the minute diuresis.
Tubular reabsorption is determined by the difference between glomerular filtration and minute diuresis and is expressed as a percentage. The tubular reabsorption of CR is calculated using the formula:
KR \u003d KF – Dx100
KF
Normal: Normally, glomerular filtration varies from 80 – 160 ml / min.
Tubular reabsorption normally ranges from 97 – 99%.

Clinical and diagnostic value.
A decrease in glomerular filtration is observed in acute and chronic glomerulonephritis, nephrosclerosis. In these diseases, a decrease in glomerular filtration is preceded by a violation of the concentration ability of the kidneys.
A decrease in tubular reabsorption is observed in acute and chronic pyelonephritis, chronic glomerulonephritis, nephrosclerosis and other diffuse kidney lesions. The degree of decrease in glomerular filtration and tubular reabsorption is of prognostic value.

Preparation

For
research, blood is taken from a vein and daily urine. Defined indicators:
1) blood creatinine; 2) urine creatinine; 3) glomerular filtration 4)
tubular reabsorption; 5) minute diuresis. Preparation for donating blood:
the night before – a light dinner, do not have breakfast on the day of blood sampling. Can I drink
water without gas in the usual amount. The day before and on the day of the study
avoid taking diuretics, avoid emotional and physical
exercise, avoid alcohol. Rules for collecting urine. Daily urine
collected within 24 hours on a normal drinking regimen (1. 5 – 2 liters per day). Suitable for collection clean
enameled or glass container with a volume of 3 liters. capacity pre
washed with laundry soap and rinsed. In the morning at 6 o’clock is released in
toilet bladder, and then during the day the patient urinates into
prepared container under normal drinking conditions. Need to complete collection
exactly at 6 a.m. the next day. It is necessary to fix the exact volume
urine collected per day. Then you need to pour about 100 ml of urine into a plastic
container and deliver to the laboratory. Volume of urine excreted per day
it is necessary to tell the registrar of the clinical diagnostic laboratory (for 2
floor) before the delivery of the biomaterial. Single urine. Urine is collected in the morning on an empty stomach
immediately after sleep, with free urination and after toilet external
genitals. To collect urine from infants, use special
urinals (sold in a retail pharmacy chain) Urine from a urinal
should be poured into a container and delivered to the laboratory.