Sterilization Through Tubal Ligation or Removal (Salpingectomy)

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Sterilization is a fallopian tube surgery performed to permanently prevent pregnancy. It is sometimes referred to as permanent birth control. The two types of female sterilization are tubal ligation (having one’s “tubes tied”) and tubal removal.

The benefits of sterilization are permanent pregnancy prevention and the elimination of the need to use other forms of birth control.

Risks of sterilization are the same for any surgery, such as infection, tissue damage or blood loss. Less than 1% of tubal ligation sterilizations are not effective. Sexually transmitted infections can still occur after sterilization, and additional protection against STIs is recommended.

What is female sterilization?

Female sterilization is a surgical procedure that results in the permanent prevention of pregnancy by disrupting the fallopian tubes’ role in conception. There are two surgical options, tubal ligation and tubal removal. Both can be conducted using laparoscopy, a minimally invasive surgery which has a short recovery time and little to no scarring.

Removal and ligation can also be done via minilaparotomy involving a larger incision and bringing the tubes through the incision to perform the removal or tying. This is most often done right after childbirth when the fallopian tubes are higher in the abdomen.

Tubal ligation (tubes tied)

Tubal ligation is sometimes referred to as getting one’s tubes tied. This procedure includes the cutting or sealing of the fallopian tubes where fertilization occurs. This procedure prevents sperm from reaching the egg so fertilization does not occur.

The surgery is typically performed using laparoscopy. This involves small incisions through which our surgeon inserts a tiny camera to provide a view of the tubes on an external monitor and special instruments to perform the tying/blocking. It has a very low failure rate with fewer than 1 in 100 women becoming pregnant within 1 year of having surgery. While it is possible to reverse a tubal ligation surgically, it is not always successful in restoring fertility.

Tubal removal (salpingectomy)

Tubal removal, also known as a complete salpingectomy, is the removal of one or both fallopian tubes. Removing only one fallopian tube (unilateral salpingectomy) can still allow for pregnancy, but removing both tubes (bilateral salpingectomy) provides permanent birth control.

This procedure has an even lower chance of accidental pregnancy than tubal ligations, but it cannot be reversed.

Benefits of sterilization

Sterilization is safe for almost all women and can provide some peace of mind for those who do not wish to get pregnant. It does not carry some of the ongoing side effects of other forms of nonpermanent birth control, such as birth control pills or intrauterine devices, as it does not affect hormones, menstruation or sexual desire.

Some studies suggest that female sterilization may decrease the risk of ovarian cancer. The risk may be decreased more with full removal of the tubes (bilateral salpingectomy) than with tubal ligation.

Who should consider sterilization?

Female sterilization is a good option for women who do not want to become pregnant in the future. Women may choose to undergo this surgery if:

• They do not wish to have children or add more children to their family.
• Pregnancy would be a health risk.
• They do not want to pass on a genetic disorder from themselves or their partner.

Patients should have a conversation with their OB-GYN or primary care physician if they are interested in sterilization. There are many birth control options available, and either the male partner or the female partner can be sterilized. The guidance of one of our medical experts can help the decision-making process become easier.

Female sterilization FAQ

Q: Will I still experience a menstrual period after tubal ligation or tubal removal?
A: Yes.

Q: Does sterilization protect me from sexually transmitted infections?
A: No. Additional protection should be used to prevent the spread of infections.

Q: Can female sterilization be reversed?
A: Tubal ligations may be reversed, but there is no guarantee the reversal will allow for a woman to become pregnant. Tubal removals are not reversible.

Q: Is the sterilization immediate after surgery?
A: Yes.

Q: Will tubal removal also remove my ovaries?
A: No.

Q: How long do I have to stay in the hospital after surgery?
A: Most women without prior health concerns are able to return home the day of the surgery.

Q: What is the typical recovery time after female sterilization?
A: Recovery typically takes 1 to 3 weeks after surgery, though it could take longer if surgery was performed after a cesarean section or childbirth.

Q: Will female sterilization help with my hormone imbalance?
A: No, removal or blocking of the fallopian tubes does not affect hormone balance.

Complications & side effects of tubal ligation and tubal removal

As with any surgical procedure, there are certain risks when undergoing sterilization. There is a chance of side effects from anesthesia as well as damage to other organs inside the abdomen during surgery. Although rare, infections and bleeding may occur.

Even more rare, the fallopian tubes may spontaneously heal after a tubal ligation, leading to unplanned pregnancy that can potentially be ectopic. An ectopic pregnancy develops when the fetus implants in the fallopian tube instead of the uterus. This type of pregnancy cannot be carried and must be terminated.

Options beyond sterilization

Sterilization is not meant for women who may want to become pregnant in the future. If a woman is interested in preventing pregnancy in a nonpermanent way, there are other options that may better fit her needs such as:

• Intrauterine devices (IUD).
• Vaginal rings.
• Birth control implants.
• Birth control pills, shots and patches.
• Condoms.
• Spermicide.
• Abstinence.