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Tubal ligation as a surgical contraception for women
Tubal ligation as a surgical contraception for women
Anonim

Tubal ligation is the method of contraception that most reliably protects against unwanted pregnancy. Despite the fact that women voluntarily decide on this operation, it does not guarantee 100% sterility. To the question: is it possible to become pregnant after ligation of the fallopian tubes, it is impossible to give an unequivocally negative answer.

After 5 years, fertility can be restored in 5 cases out of 1000, and after 10 years, the possibility of getting pregnant returns already in 1.8%.

However, it should be noted that such unpleasant facts were noted when the sterilization was performed incorrectly, or when the ligation of the fallopian tubes during cesarean section was not noticed the adhesive process, which caused their abnormal fusion of the fallopian tubes with the formation of a new passage.

The development of the embryo is possible when the operation was performed in a woman with a short pregnancy - at the stage when the egg has already left the fallopian tube, but has not yet penetrated into the lining of the uterus, so the tests did not show the onset of pregnancy.

Such a case is considered a medical incident.

Such a pregnancy develops normally, since sterilization has no effect on the state of the placenta or the course of pregnancy.

Bandaging methods

One of the simplest methods - if we consider the rehabilitation process - is laparoscopic surgery.

They are carried out in two ways:

  • conventional laparoscopy;
  • mini-laparotomy.

The operations are performed under local or general anesthesia, at the request of the patient.

  1. During the procedure of tubal sterilization, punctures are made above the pubis, into one of which an endoscope is inserted, and into the others - special levers-probes.
  2. Carbon dioxide is blown into the peritoneal cavity - to improve visibility - then the fallopian tubes are sealed or closed with a ring or flip.
  3. With mini-paws, the seam does not exceed 4 cm in length. Part of the pipe is excised before sealing, which excludes the possibility of becoming pregnant completely.

With a caesarean section, tubal ligation is performed at the request of the woman, or if her health is in danger. Caesarean sections can be performed using laparoscopy or open surgery.

If a woman has inflammation in the pelvic area, then a sterilization operation may also be required. Indications for its implementation are diagnoses: endometriosis, endometritis, chronic inflammatory processes of the appendages and fallopian tubes.

Postpartum sterilization can be performed using the laparoscopic method - it is performed within 72 hours after the birth of the baby. At this time, the fallopian tubes are located at the level of the navel, which facilitates the operation, and accordingly the rehabilitation process is accelerated.

Sterilization can be performed without surgery using the tubular implant method. They are inserted without general or epidural anesthesia. The procedure takes about 30 minutes.

The woman is on the gynecological chair.

  • Local anesthesia is performed - an injection of an anesthetic;
  • then the cervix is opened;
  • in turn, a catheter is inserted into the tubes, with the help of which implants are inserted into them.

Thanks to implants, scar tissue forms in the tube, which clogs it tightly. Until the scar tissue has formed, pregnancy can occur. To prevent undesirable consequences from happening, this method is carried out under X-ray control.

3 months after the procedure, you need to carefully protect yourself, then take a picture, having previously introduced a dye into the fallopian tubes. This control is called hysterosalpingography. If the scar tissue has formed and the tubes are completely blocked, there is no need for protection.

If a cesarean section or open surgery on the suprapubic zone requires a long rehabilitation process, and a rough scar is a significant cosmetic defect, then these problems do not arise during a culdoscopic operation.

Surgical intervention is performed in the following way: the introduction of implants or ligation of the fallopian tubes is carried out through the back wall of the vagina.

Consequences of tubal ligation in various ways

  • After the sterilization procedure, which is performed on an outpatient basis, cramping pains in the lower abdomen may appear, reminiscent of the cramps during the menstrual cycle. In addition, in the first days, intestinal upset, increased gas production, nausea, and dizziness sometimes occur.
  • After laparoscopic surgery, the patient is allowed to go home the next day. After such an intervention and a culdoscopic operation, women experience soreness at the puncture site, weakness, the first days there may be pulling pains in the lower abdomen - they can be eliminated with the help of anesthetics.
  • In case of poorly performed surgical intervention, there is a likelihood of developing an inflammatory process of a purulent nature at the site of the introduction of medical equipment, the development of bleeding, an allergy to anesthesia.
  • Undesirable consequences after ligation of the fallopian tubes during cesarean section, made by an open method, arise due to the patient's individual susceptibility to anesthesia or drugs, sometimes appear with insufficiently high-quality operation.

The first postoperative complications:

  1. suppuration of the seams;
  2. general rise in temperature;
  3. the appearance of bleeding.

In the future, an adhesive process may occur, which in severe cases causes intestinal obstruction, the occurrence of postoperative hernia, changes in the position of the uterus. It may bend backward, resulting in soreness during menstrual cycles.

Years later, endometriosis may develop not only of the uterine mucosa, but also of a skin scar - if endometrial tissue gets on it during the operation.

The most unpleasant consequence of a cesarean section or an open sterilization operation is the scar itself.

But if you follow the rules of wound care:

  • do not wet the scar until the stitches are removed;
  • do not lift weights until the wound is completely healed;
  • after scarring, apply gels and ointments that prevent keloid formation;
  • for the first 2 months after the operation, do not sunbathe and do not go to saunas or baths;
  • avoid rubbing the scar with clothing -

the seam will be practically invisible, and it will be possible not to consider it as an aesthetic defect.

Pros and cons of tubal ligation

Ripe eggs are absorbed in the abdominal cavity, and the fear of unwanted pregnancy disappears in women. The positive consequence of sterilization is that the quality of the sexual life increases.

Tubal ligation in women does not cause consequences in the form of hormonal changes, decreased libido or menstrual irregularities. Menopause occurs at a time predetermined by nature - the impossibility of getting pregnant does not bring it closer.

A woman can behave in exactly the same way as before the operation.

Cons of sterilization

  • The risk of contracting a sexually transmitted disease does not disappear;
  • does not eliminate the possibility of developing gynecological diseases - adnexitis, bacterial vaginitis or vulvovaginitis and others;
  • the main disadvantage is that the operation is irreversible.

Therefore, when deciding on sterilization, a woman should carefully weigh the pros and cons, consult with a doctor and spouse, if any.

Before irreversible sterilization, permission for the operation is issued legally. A woman is required to be questioned about the state of health, stability of the family, warn that if circumstances change, it is almost impossible to return the ability to conceive.

Almost - since at this stage of the development of modern medicine, the dressing can be eliminated - however, only in 14-23% of patients.

There are no contraindications to surgery

  • When pregnancy and childbirth threaten the health or life of a woman;
  • in premenopausal age, if there are severe hereditary genetic diseases;
  • already have 2 or more children, the woman is less than 35 years old;
  • a woman over 35 already has a child;
  • spouses' desires not to have children completely coincide.

There are practically no complications during the operation - however, an individual allergic reaction to anesthesia methods may appear.

If sterilization is carried out in a non-open way, then there is a risk of damage to internal organs.

Take care of yourself and make informed decisions!

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