Our Summary

This study aimed to compare two methods of sterilization at the time of cesarean delivery: salpingectomy (removal of fallopian tubes) and standard bilateral tubal ligation (tying off the fallopian tubes). The researchers wanted to see which method was more feasible in terms of operation time and successful completion.

A total of 80 women who were at least 35 weeks pregnant and did not want more children were randomly assigned one of the two procedures after their C-section operations had started. If the removal of the fallopian tubes couldn’t be done, the tubes were tied off instead.

The researchers found that tying off the tubes was successful in more cases (95% compared to 68% for tube removal). Also, the tube removal procedure took on average 15 minutes longer. However, there were no negative outcomes directly related to either sterilization procedure. While the surgeons estimated that the tube removal procedure resulted in a slightly higher blood loss, the overall blood loss and safety outcomes did not differ significantly between the two groups.

In conclusion, the removal of fallopian tubes as a method of permanent contraception during cesarean delivery is feasible, but it takes a bit longer and is less likely to be successfully completed than simply tying off the tubes.

FAQs

  1. What were the two methods of sterilization compared in this study?
  2. How successful was the procedure of tying off the tubes compared to the removal of fallopian tubes?
  3. Were there any significant differences in safety outcomes between the two sterilization methods?

Doctor’s Tip

A doctor might tell a patient considering bilateral tubal ligation that both methods (removal of fallopian tubes and tying off the tubes) are safe and effective options for permanent contraception. They may also mention that while removing the tubes may take a bit longer and have a slightly higher risk of blood loss, both procedures have similar overall safety outcomes. Ultimately, the choice between the two methods may depend on individual factors and preferences.

Suitable For

Patients who are looking for a permanent form of contraception and are undergoing a cesarean delivery may be recommended for bilateral tubal ligation. Additionally, patients who are at high risk for ovarian cancer or 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 on bilateral tubal ligation as their preferred method of sterilization
  • Patient schedules appointment for the procedure
  • Patient may undergo pre-operative testing and counseling

During bilateral tubal ligation:

  • Patient is prepped for surgery
  • Patient is administered anesthesia
  • Surgeon makes small incisions in the abdomen to access the fallopian tubes
  • Surgeon ties, cuts, or seals off the fallopian tubes to prevent eggs from traveling to the uterus
  • Procedure typically takes around 30 minutes to complete
  • Patient is monitored in recovery before being discharged home

After bilateral tubal ligation:

  • Patient may experience some pain, discomfort, or bloating at the incision sites
  • Patient may experience some vaginal bleeding or discharge
  • Patient is advised to avoid heavy lifting or strenuous activities for a few days
  • Patient may need to follow up with their healthcare provider for a post-operative appointment
  • Patient is advised to use alternative forms of contraception until their sterilization is confirmed to be effective (usually after a follow-up appointment)

What to Ask Your Doctor

  1. What are the potential risks and complications associated with bilateral tubal ligation?

  2. How does the procedure of tying off the fallopian tubes compare to the removal of the fallopian tubes in terms of effectiveness?

  3. Is there a difference in recovery time between the two methods of sterilization?

  4. Will the removal of fallopian tubes or tying off the tubes affect my hormone levels or menstruation cycle?

  5. Are there any long-term health implications associated with either method of sterilization?

  6. Will either method of sterilization increase my risk of ectopic pregnancy in the future?

  7. Are there any alternative methods of permanent contraception that I should consider?

  8. How soon after the procedure can I resume normal activities and sexual intercourse?

  9. What follow-up care will be necessary after the sterilization procedure?

  10. Are there any factors that may make me a better candidate for one method of sterilization over the other?

Reference

Authors: Subramaniam A, Blanchard CT, Erickson BK, Szychowski J, Leath CA, Biggio JR, Huh WK. Journal: Obstet Gynecol. 2018 Jul;132(1):20-27. doi: 10.1097/AOG.0000000000002646. PMID: 29889762