Our Summary

This research paper is about a study that looked at how often total salpingectomy (TS), a procedure where both fallopian tubes are removed, was performed compared to occlusion or partial salpingectomy (PS), where the tubes are either blocked or partially removed, during cesarean deliveries (C-sections). The researchers looked at medical records from two hospitals over a five-year period.

They found that total salpingectomy was performed in 14% of the cases. The likelihood of having a total salpingectomy instead of a partial one or occlusion was higher for patients with public insurance or who paid themselves, those who gave birth at the community hospital, those who had given birth five or more times before, and those who had an obstetrician or gynecologist perform their C-section.

The time it took to perform the procedures was also compared. At the academic hospital, total salpingectomy took longer (90 minutes) than occlusion or partial salpingectomy (68 minutes). However, at the community hospital, there was no significant time difference between the two procedures.

In simpler terms, this study found that the type of birth control procedure a woman gets during her C-section can depend on things like her insurance, where she gives birth, how many times she has given birth before, and who performs her C-section. The study could help create programs that increase the use of total salpingectomy during C-sections, as it’s a highly effective permanent birth control method.

FAQs

  1. What is the difference between total salpingectomy and occlusion or partial salpingectomy?
  2. What factors were found to affect the likelihood of a woman receiving a total salpingectomy during her C-section?
  3. Was there a significant time difference between performing a total salpingectomy and occlusion or partial salpingectomy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about bilateral tubal ligation is that total salpingectomy, where both fallopian tubes are removed, is a highly effective permanent birth control method. It may be a good option for patients who are sure they do not want to have any more children. It is important to discuss the potential risks and benefits of the procedure with your healthcare provider before making a decision.

Suitable For

Patients who are typically recommended bilateral tubal ligation, whether through total salpingectomy or other methods, include those who are looking for a permanent form of birth control, women who have completed their desired family size, or individuals who have medical conditions that make pregnancy risky. Additionally, patients who have a high risk of ectopic pregnancy, a history of recurrent pelvic infections, or a family history of ovarian or breast cancer may also be recommended bilateral tubal ligation. Ultimately, the decision to undergo this procedure should be made in consultation with a healthcare provider based on individual circumstances and preferences.

Timeline

Before bilateral tubal ligation:

  1. Patient discusses permanent birth control options with their healthcare provider.
  2. Patient makes the decision to undergo bilateral tubal ligation.
  3. Patient schedules the procedure and completes any necessary pre-operative tests.
  4. On the day of the procedure, patient arrives at the hospital or surgical center and undergoes the surgery under general anesthesia.
  5. The surgeon makes small incisions in the abdomen and seals or removes both fallopian tubes to prevent the eggs from traveling to the uterus.

After bilateral tubal ligation:

  1. Patient wakes up from anesthesia in the recovery room.
  2. Patient may experience some pain and discomfort at the incision sites.
  3. Patient is discharged home the same day or after a short hospital stay.
  4. Patient is advised to rest and avoid strenuous activities for a few days.
  5. Patient may experience some vaginal bleeding or spotting.
  6. Patient follows up with their healthcare provider for a post-operative check-up.
  7. Patient resumes normal activities within a week or two.
  8. Patient no longer needs to worry about contraception or the risk of pregnancy.

What to Ask Your Doctor

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

  1. What are the different types of bilateral tubal ligation procedures available, and which one do you recommend for me?
  2. What are the risks and potential complications associated with bilateral tubal ligation?
  3. How effective is bilateral tubal ligation as a form of permanent birth control?
  4. Will I still have regular menstrual cycles after undergoing bilateral tubal ligation?
  5. How long is the recovery period after bilateral tubal ligation, and when can I resume normal activities?
  6. Are there any alternative forms of permanent birth control that I should consider?
  7. Will bilateral tubal ligation affect my hormone levels or overall health in any way?
  8. How soon after bilateral tubal ligation can I expect to be sterile and no longer at risk of pregnancy?
  9. Are there any long-term effects or considerations I should be aware of after undergoing bilateral tubal ligation?
  10. What should I do if I change my mind about wanting to become pregnant in the future after undergoing bilateral tubal ligation?

Reference

Authors: Desravines N, Brenner T, Venkatesh K, Stuart G. Journal: Contraception. 2021 Mar;103(3):203-207. doi: 10.1016/j.contraception.2020.12.001. Epub 2020 Dec 17. PMID: 33345975