Our Summary

This paper discusses a condition known as Postablation Tubal Sterilization Syndrome (PATSS), which is a rare side effect of a certain type of surgery for female sterilization. Women with this condition experience regular pelvic pain due to the build-up of blood and tissue in blocked parts of the fallopian tubes. Most previous reports on this condition have focused on the clinical and radiological findings. However, this study aims to provide a more detailed description of the physical and microscopic changes seen in patients suffering from this condition.

Three patients who had undergone sterilization and ablation (removal of the lining of the uterus) and then had their uterus and ovaries removed due to pelvic pain were studied. In two of these patients, doctors had suspected PATSS before the study.

In all three patients, the study found similar changes - blood-filled tubes, a build-up of iron-containing materials, inflammation, and changes in the uterine lining and muscle tissue. All these changes, along with the clinical and radiological findings, suggested that the patients were suffering from PATSS.

It’s estimated that this condition affects 5% to 10% of women who have undergone endometrial ablation, but it’s believed that many cases go unreported due to lack of awareness. The authors suggest that pathologists (doctors who study diseases by examining cells and tissues) should consider the possibility of PATSS in women who have undergone a hysterectomy and show these specific changes. They believe this is the first study to describe the microscopic features of PATSS.

FAQs

  1. What is Postablation Tubal Sterilization Syndrome (PATSS)?
  2. What are the symptoms and physical changes seen in patients with PATSS?
  3. What percentage of women who undergo endometrial ablation are estimated to be affected by PATSS?

Doctor’s Tip

If you are considering bilateral tubal ligation, it’s important to discuss the potential risks and side effects with your doctor. In rare cases, a condition called Postablation Tubal Sterilization Syndrome (PATSS) can occur, leading to pelvic pain and other symptoms. Be sure to communicate any concerns or symptoms you may experience after the procedure with your healthcare provider.

Suitable For

Women who have undergone sterilization and endometrial ablation and continue to experience pelvic pain are typically recommended bilateral tubal ligation. This includes women who have had a history of heavy menstrual bleeding, fibroids, or other gynecological conditions that may have led to the original surgery. Additionally, women who have had a hysterectomy due to persistent pelvic pain after sterilization and ablation may also be recommended bilateral tubal ligation.

Timeline

Before bilateral tubal ligation:

  1. Patient discusses sterilization options with healthcare provider.
  2. Patient decides to undergo bilateral tubal ligation as a permanent form of contraception.
  3. Patient undergoes pre-operative assessment and counseling.
  4. Patient schedules surgery and prepares for the procedure.
  5. Patient undergoes bilateral tubal ligation surgery, which involves blocking or sealing the fallopian tubes to prevent eggs from reaching the uterus.

After bilateral tubal ligation:

  1. Patient may experience some pain, discomfort, and bloating immediately after surgery.
  2. Patient is monitored for any complications in the recovery room.
  3. Patient is discharged from the hospital or surgical center and instructed on post-operative care.
  4. Patient may experience some mild side effects such as cramping, spotting, or vaginal discharge in the days following surgery.
  5. Patient follows up with healthcare provider for post-operative check-ups and to discuss any concerns or symptoms.
  6. Patient experiences the long-term benefits of bilateral tubal ligation, such as permanent contraception and peace of mind.
  7. Patient may need to adjust to any changes in menstrual cycles or hormonal balance post-surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about bilateral tubal ligation and the potential risk of Postablation Tubal Sterilization Syndrome (PATSS) include:

  1. What are the potential risks and side effects associated with bilateral tubal ligation?
  2. Are there any specific symptoms or warning signs I should watch out for after undergoing this procedure?
  3. How common is PATSS, and what are the typical symptoms associated with this condition?
  4. What diagnostic tests or imaging studies can be done to confirm a diagnosis of PATSS?
  5. What treatment options are available for managing PATSS, if it were to occur?
  6. Are there any long-term implications or complications associated with PATSS?
  7. How often should I follow up with my healthcare provider after undergoing bilateral tubal ligation to monitor for any potential complications?
  8. Are there any lifestyle changes or precautions I should take to reduce the risk of developing PATSS?
  9. Are there any alternative sterilization methods that may carry a lower risk of developing PATSS?
  10. Can you provide me with more information or resources about PATSS for further reading or understanding?

Reference

Authors: Butnor KJ, Bartlett JR. Journal: Am J Surg Pathol. 2018 Jun;42(6):786-790. doi: 10.1097/PAS.0000000000001043. PMID: 29505424