Tubal Occlusion

Tubal occlusion, commonly known as “having your tubes tied”, is a permanent method of birth control for women. It is achieved by an operation to permanently block both fallopian tubes. This prevents sperm from fertilising an egg.

The main reasons for a tubal occlusion are:

  • The woman is certain she does not want any more children
  • It is a very effective form of contraception
  • The woman’s health would be threatened by pregnancy.

Advantages of Tubal Occlusion

  • Tubal occlusion is a more reliable and permanent method of contraception than some other methods
  • The woman does not have to remember to take a contraceptive pill everyday
  • Tubal occlusion does not upset the menstrual bleeding pattern (although bleeding may be heavier than periods produced by the contraceptive pill)
  • There are no chemicals or devices to put in or take out at the time of sexual intercourse (for example a diaphragm or female condom)
  • There are no on-going costs, as there are with some other methods of contraception.

Tubal Occlusion and Femininity

Tubal occlusion does not prevent ovulation. Each month either ovary will continue to produce a mature egg, and you will have a menstrual period as usual. The egg is absorbed by the body.

Your ovaries will still produce those female hormones which affect some aspects of femininity, such as hair, voice, sex drive and breast size. You will not gain weight or develop facial hair due to tubal occlusion.

Tubal occlusion does not reduce sexual desire (libido). In fact, many women find that they feel less tension about the risk of an unwanted pregnancy after tubal occlusion.

Before surgery

It is important that you are not pregnant at the time of tubal occlusion. It is very important that you take precautions right up to the time you come into hospital.

Surgical Methods of Tubal Occlusion

Laparoscopic tubal occlusion

The gynaecologist makes a small incision close to the lower edge of the navel and inserts a long, thin instrument with a light and viewing lens calls a laparoscope. This is often called “key-hole” surgery. The bladder may be emptied with a urinary catheter.
Your gynaecologist may insert an instrument for closing the tubes, usually through a second small incision near the pubic hairline. Several methods may be used to block both fallopian tubes during laparoscopy:

  • Clamping each with a clip
  • Applying plastic rings around the tubes
  • Using diathermy to burn the full thickness of the tubes and close them.

Reversal of Tubal Occlusion (Tubal Reanastomosis)

Tubal reanastomosis is the surgical procedure which rejoins fallopian tubes that have previously been blocked by a tubal-occlusion procedure. This is major surgery and usually takes about one hour.

It involves complex and delicate microsurgery to remove the damaged portions of the tubes and bring the two cut ends precisely together. One or both fallopian tubes can be successfully rejoined in many cases.

The likelihood of success depends on the surgical method that was used to block the fallopian tubes and on the length of the tube left intact after tubal occlusion. Following reversal, the chances of falling pregnant are best for women younger than 38 years. The risk of ectopic pregnancy is increased by reversal of tubal occlusion.