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.
Preoperative preparation entails taking a good history to be able to medically know the patient better. Simple things like the name, age, residence and whether they are married or not should not be assumed. Obstetric and gynecological history is also key. The patient should tell doctor how many deliveries they have had and whether they were done vaginally or through an operation. In addition, information regarding how many pregnancies have been lost is important. In light of this, the doctor striking and good rapport with the woman goes a long way in getting detailed medical information.
The doctor needs to do a focused physical examination to determine the stability of the patient for the planned operation. Certain investigations including blood tests and imaging studies are also required just as is the case with many other operations. The commonest imaging technique utilized is a pelvic ultrasound. A pelvic radiographic film with contrast enables the gynecologist to know the remaining size of oviducts and whether or not they can be modified to start working normally again.
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.
The chances of success in the reversal operation depends on a number of factors. Studies have shown that women above the age of forty stand a lower chance of getting pregnant even after reversal surgery. Women who have several previous surgeries tend to have massive adhesions in their pelvic cavities which may result in obstruction. In addition, if there were other unsorted infertility issues, pregnancy may be difficult to achieve. Skill and experience of the surgeon is also counts a major determinant to the overall success.
Infection, blood loss and injury to other structures in the pelvic region are some of the common complications of fallopian tubal ligation reversal surgery. Ultimately, scarves tissue gets deposited in the oviducts again and blocks them. The likelihood of a fetus implanting elsewhere other than the womb is higher after reversal operation.
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 summary, it should be stated that tubal ligation is not necessarily permanent. It can be reversed by removing the rings or clips along the tube. Laparoscopy or open surgery are the two main surgical options. Age is a major contributory factor in the success of the intervention. Those above the age of forty stand a smaller chance of success.
Preoperative preparation entails taking a good history to be able to medically know the patient better. Simple things like the name, age, residence and whether they are married or not should not be assumed. Obstetric and gynecological history is also key. The patient should tell doctor how many deliveries they have had and whether they were done vaginally or through an operation. In addition, information regarding how many pregnancies have been lost is important. In light of this, the doctor striking and good rapport with the woman goes a long way in getting detailed medical information.
The doctor needs to do a focused physical examination to determine the stability of the patient for the planned operation. Certain investigations including blood tests and imaging studies are also required just as is the case with many other operations. The commonest imaging technique utilized is a pelvic ultrasound. A pelvic radiographic film with contrast enables the gynecologist to know the remaining size of oviducts and whether or not they can be modified to start working normally again.
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.
The chances of success in the reversal operation depends on a number of factors. Studies have shown that women above the age of forty stand a lower chance of getting pregnant even after reversal surgery. Women who have several previous surgeries tend to have massive adhesions in their pelvic cavities which may result in obstruction. In addition, if there were other unsorted infertility issues, pregnancy may be difficult to achieve. Skill and experience of the surgeon is also counts a major determinant to the overall success.
Infection, blood loss and injury to other structures in the pelvic region are some of the common complications of fallopian tubal ligation reversal surgery. Ultimately, scarves tissue gets deposited in the oviducts again and blocks them. The likelihood of a fetus implanting elsewhere other than the womb is higher after reversal operation.
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 summary, it should be stated that tubal ligation is not necessarily permanent. It can be reversed by removing the rings or clips along the tube. Laparoscopy or open surgery are the two main surgical options. Age is a major contributory factor in the success of the intervention. Those above the age of forty stand a smaller chance of success.
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