Our Summary

This research paper looks into the practice of complete bilateral salpingectomy (CBS) - the removal of both fallopian tubes - during cesarean delivery (CD) or C-section births. CBS can lower the risk of ovarian cancer, but it’s not commonly done during CD. The researchers wanted to see if an educational campaign could increase the use of CBS in these cases. They compared the rates of CBS during CD before and after an educational presentation given to doctors who perform CDs. They also surveyed these doctors to see how many offered CBS during CD and how comfortable they were with the procedure.

After the educational presentation, the rates of CBS during CD increased significantly - from 5.1% to 31.8% within a year, and up to 52% in the last quarter of the study. The surgical outcomes for CBS were similar to those for tubal ligation (another form of permanent contraception), but CBS took about 5 minutes longer. In the survey, all the doctors said they offered CBS during hysterectomy and interval sterilization, but only 36% offered it during CD. More doctors felt comfortable performing CBS using a technique called bipolar electrocautery (90%) than suture ligation (56%).

In conclusion, the educational presentation was effective in increasing the use of CBS during CD.

FAQs

  1. What is complete bilateral salpingectomy (CBS) and how does it relate to C-section births?
  2. How did the educational campaign impact the rates of CBS during C-section deliveries?
  3. What were the survey results regarding doctors’ comfort levels with performing CBS during CD?

Doctor’s Tip

A helpful tip a doctor might tell a patient considering bilateral tubal ligation is that it can be done during a cesarean delivery as a way to reduce the risk of ovarian cancer. Patients should discuss this option with their doctor to see if it is a suitable choice for them.

Suitable For

Patients who are typically recommended bilateral tubal ligation are those who are seeking a permanent form of contraception and are done having children. Additionally, patients who are at high risk for ovarian cancer or who have a family history of ovarian cancer may also be recommended for bilateral tubal ligation as a preventative measure.

Timeline

Before bilateral tubal ligation:

  • Patient discusses permanent contraception options with their healthcare provider
  • Patient decides to undergo bilateral tubal ligation
  • Patient receives information about the procedure, risks, and benefits
  • Patient schedules the surgery and receives pre-operative instructions

After bilateral tubal ligation:

  • Patient undergoes the surgery, which typically takes less than an hour
  • Patient is monitored in the recovery room before being discharged
  • Patient may experience some pain, discomfort, and bloating after the surgery
  • Patient is advised to rest and avoid strenuous activities for a few days
  • Patient may experience some vaginal bleeding or discharge
  • Patient follows up with their healthcare provider for a post-operative check-up
  • Patient resumes normal activities, knowing they are now permanently sterilized.

What to Ask Your Doctor

Some questions a patient should ask their doctor about bilateral tubal ligation include:

  1. What are the risks and benefits of bilateral tubal ligation compared to other forms of permanent contraception?
  2. How does the procedure of bilateral tubal ligation during cesarean delivery differ from a traditional tubal ligation surgery?
  3. What is the success rate of bilateral tubal ligation in preventing pregnancy?
  4. Are there any long-term side effects or complications associated with bilateral tubal ligation?
  5. How soon after the procedure can I expect to resume normal activities?
  6. Is there a possibility of the fallopian tubes growing back together after bilateral tubal ligation?
  7. Will I still have normal menstrual cycles after the procedure?
  8. How does bilateral tubal ligation affect hormone levels in the body?
  9. Are there any alternatives to bilateral tubal ligation that I should consider?
  10. How often should I follow up with my doctor after the procedure?

Reference

Authors: DiSilvestro JB, Raker CA, Velasquez J, Mathews CA. Journal: R I Med J (2013). 2023 Jun 1;106(5):49-53. PMID: 37195163