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The fallopian tubes form a vital part of the female reproductive system. It links the ovaries on either side to the uterus. Eggs released from the ovaries find their way to the fallopian tubes where they meet with sperms for fertilization. Tying the fallopian tubes bilaterally interferes with the natural conception process. Tubal reversal surgery is ideal for women whose tubes may have been tied accidentally or those who change their minds regarding this method of family planning.
History, physical examination and investigations are necessary before the doctor decides that surgery can be undertaken. A good rapport should be created between the doctor and the patient so that relevant medical details can be revealed. Any past illnesses involving the genitourinary system should be documented. This could be infection, malignancy, congenital malformations and so on. Any operations done previously should also be taken in to consideration. Common operations that can interfered with reversal include myomectomy, cesarean section, management of an ectopic pregnancy and so on.
A focused physical examination is necessary in ruling out other causes of infertility such as an intact hymen or an incompetent cervix. Examination also helps to pick up any existing infections which need to be treated first before operation. Some of the priority investigations performed following physical examination include a pelvic ultrasound and a special procedure called a hysterosalpingogram (HSG). These two combined help determine the status of the oviducts in terms of length and functionality.
Either laparoscopy or open operation is employed during this operation. Even though it has a high learning curve, , laparoscopy enjoys the advantage of being less invasive and shorter in duration. The operation unties the ligatures and join back the tubes. The patient is put under general anaesthesia to facilitate a painless procedure.
One of the common factors that may render the operation useless is age. Women below the age of forty stand a better chance of conceiving than those above. A history past pelvic operations causes and increase in adhesion formation which may end up clogging the tube again. Moreover, couples with other underlying issues with their fertility have very little chance of success in pregnancy if these are not sorted out.
Complications of ligation reversal surgery are bound to happen, just like in any other surgical procedure. During the intra operative period, the patient may bleed excessively. Apart from bleeding, damage to surrounding structures is also a possibility. Infection may come later on during the recovery period. Formation of scar tissue is another bother as it may result in tubes getting blocked again. The chances of getting ectopic pregnancies after reversal are very high.
Some of these complications can be minimized by observing certain measures including administration of prophylactic antibiotics and observing sterility when handling the internal environment of the body. In addition, blood tests should be done before the operation to ensure the hemoglobin levels are within normal to cater for blood loss during surgery.
In conclusion, there is room for reversal even after tubal ligation. The size of the remaining tubes determines whether the procedure will be successful or not. It is done by unclipping the area and suturing together the open ends. Women below the age of forty are more likely to get pregnant after the reversal operation.
History, physical examination and investigations are necessary before the doctor decides that surgery can be undertaken. A good rapport should be created between the doctor and the patient so that relevant medical details can be revealed. Any past illnesses involving the genitourinary system should be documented. This could be infection, malignancy, congenital malformations and so on. Any operations done previously should also be taken in to consideration. Common operations that can interfered with reversal include myomectomy, cesarean section, management of an ectopic pregnancy and so on.
A focused physical examination is necessary in ruling out other causes of infertility such as an intact hymen or an incompetent cervix. Examination also helps to pick up any existing infections which need to be treated first before operation. Some of the priority investigations performed following physical examination include a pelvic ultrasound and a special procedure called a hysterosalpingogram (HSG). These two combined help determine the status of the oviducts in terms of length and functionality.
Either laparoscopy or open operation is employed during this operation. Even though it has a high learning curve, , laparoscopy enjoys the advantage of being less invasive and shorter in duration. The operation unties the ligatures and join back the tubes. The patient is put under general anaesthesia to facilitate a painless procedure.
One of the common factors that may render the operation useless is age. Women below the age of forty stand a better chance of conceiving than those above. A history past pelvic operations causes and increase in adhesion formation which may end up clogging the tube again. Moreover, couples with other underlying issues with their fertility have very little chance of success in pregnancy if these are not sorted out.
Complications of ligation reversal surgery are bound to happen, just like in any other surgical procedure. During the intra operative period, the patient may bleed excessively. Apart from bleeding, damage to surrounding structures is also a possibility. Infection may come later on during the recovery period. Formation of scar tissue is another bother as it may result in tubes getting blocked again. The chances of getting ectopic pregnancies after reversal are very high.
Some of these complications can be minimized by observing certain measures including administration of prophylactic antibiotics and observing sterility when handling the internal environment of the body. In addition, blood tests should be done before the operation to ensure the hemoglobin levels are within normal to cater for blood loss during surgery.
In conclusion, there is room for reversal even after tubal ligation. The size of the remaining tubes determines whether the procedure will be successful or not. It is done by unclipping the area and suturing together the open ends. Women below the age of forty are more likely to get pregnant after the reversal operation.
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