The reproductive system is composed of the external genitalia and internal structures including the uterus, fallopian tubes and ovaries. Fallopian tubes or oviducts are a conduit for fertilized eggs to reach the womb for implantation. Some women opt to have their tubes ligated as a method of family planning. Occasionally, the tubes may be accidentally tied during pelvic operations for other reasons. Tubal reversal surgery is considered for women of reproductive age who wish to have more children.
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.
Women whose age is above forty stand minimally chances of pregnancy after reversal of fallopian tubes ligation. The presence of too many adhesions, as occurs after performing surgeries, impairs the ability of a woman to conceive even after the tubes have been untied. Underlying fertility problems may also work against a couple trying to have a child.
Comparable to other surgeries, reversal surgery can complicated with excessive blood loss, neighbouring soft tissue injury and infection which may develop later on. In the long run, fibrous tissue may form causing obstruction again. Ectopic pregnancies are also much more among women who have had their tubes untied.
Some of the complications encountered are preventable. For instance, simply maintaining sterile measures when treating the patient goes a long way in keeping infections at bay. In addition, prophylactic antibiotics can be given to provide cover. Patients with low blood volumes should be stabilized first before being taken to theatre to avoid the dangers of excessive bleeding.
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.
Women whose age is above forty stand minimally chances of pregnancy after reversal of fallopian tubes ligation. The presence of too many adhesions, as occurs after performing surgeries, impairs the ability of a woman to conceive even after the tubes have been untied. Underlying fertility problems may also work against a couple trying to have a child.
Comparable to other surgeries, reversal surgery can complicated with excessive blood loss, neighbouring soft tissue injury and infection which may develop later on. In the long run, fibrous tissue may form causing obstruction again. Ectopic pregnancies are also much more among women who have had their tubes untied.
Some of the complications encountered are preventable. For instance, simply maintaining sterile measures when treating the patient goes a long way in keeping infections at bay. In addition, prophylactic antibiotics can be given to provide cover. Patients with low blood volumes should be stabilized first before being taken to theatre to avoid the dangers of excessive bleeding.
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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