What is tubal ligation?

Jump To

Tubal ligation surgery: Overview

Tubal ligation is surgery to close your fallopian tubes. It's also called having your tubes tied.

To close your tubes, the doctor may band, burn (cauterize), tie and cut, or clip them. The doctor may also completely remove the fallopian tubes. After this, an egg can't move down your tubes and can't be fertilized. This means you can't get pregnant.

This surgery can be done in two ways. In laparoscopic surgery, a doctor puts a lighted tube (scope) and other tools through a few small cuts. These cuts are called incisions. One is just below your belly button. The other is lower on your abdomen. After this surgery, you will probably stay in the hospital for 2 to 4 hours. You can likely go back to work in 2 to 7 days.

The other type of surgery is called open surgery(mini-laparotomy). In this surgery, the doctor makes a larger incision above your pubic hairline or below your belly button. You will probably stay in the hospital for 1 to 3 days if you have this surgery. You can probably go back to work in about 1 to 2 weeks.

Surgery can be done right after you give birth (postpartum tubal ligation). Open surgery is usually used.

After the surgery, you should not be able to get pregnant. While there is a very small chance you could get pregnant, tubal ligation is a very reliable form of birth control.

Tubal ligation won't affect your menstrual cycle or when you start menopause. It also won't affect your desire for sex. But you could feel more relaxed about having sex. This is because you don't have to worry about getting pregnant.

Tubal ligation

A tubal ligation ("having your tubes tied") is a type of surgery for women that permanently prevents pregnancy (sterilization). During a tubal ligation, the fallopian tubes are closed or removed to prevent fertilization; this blocks the sperms' path to the egg.

The fallopian tubes can be cut, clamped closed, or tied off, or the ends may be sealed by applying heat (cautery). Removing the fallopian tubes is another option.

How can you care for yourself after tubal ligation or salpingectomy?

Activity

  • Rest when you feel tired.
  • Be active. Walking is a good choice.
  • Allow your body to heal. Don't move quickly or lift anything heavy until you are feeling better.
  • You may shower. Pat the incision dry. Don't swim or take a bath for the first 2 weeks, or until your doctor tells you it is okay.
  • For laparoscopic surgery, you will probably need to take 2 to 7 days off work. For open surgery, you will probably need to take 1 to 2 weeks off work. It depends on the type of work you do and how you feel.
  • Ask your doctor when it is okay for you to have sex.

Diet

  • You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
  • Drink plenty of fluids (unless your doctor tells you not to).
  • If your bowel movements are not regular right after surgery, try to avoid constipation and straining. Drink plenty of water. Your doctor may suggest fiber, a stool softener, or a mild laxative.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. The doctor will also give you instructions about taking any new medicines.
  • If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
  • Be safe with medicines. Read and follow all instructions on the label.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.

Incision care

  • If you have strips of tape on the cut (incision) the doctor made, leave the tape on for a week or until it falls off.
  • Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol. They can slow healing.
  • Keep the area clean and dry. You may cover the area with a gauze bandage if it oozes fluid or rubs against clothing.
  • Change the bandage every day.

Other instructions

  • Wear loose, comfortable clothing. For a few weeks, avoid anything that puts pressure on your belly.
  • You may want to use a heating pad on your belly to help with pain.

How well does tubal ligation surgery for birth control work?

Tubal ligation is not 100% effective at preventing pregnancy.

  • There is a slight risk of becoming pregnant after tubal ligation. This happens to about 5 out of 1,000 women after 1 year. After a total of 5 years following tubal ligation, about 13 out of 1,000 women will have become pregnant.
  • Pregnancy may occur if:
    • The tubes grow back together or a new passage forms (recanalization) that allows an egg to be fertilized by sperm. Your doctor can discuss which method of ligation is more effective for preventing tubes from growing back together.
    • The surgery was not done correctly.
    • You were pregnant at the time of surgery.

How do you prepare for tubal ligation surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • You may need to take a laxative or enema before surgery. Your doctor will tell you how to do this.
  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

What are the risks of tubal ligation surgery?

Major problems from tubal ligation aren't common.

  • Minor problems include infection and wound separation.
  • Major problems include heavy blood loss, general anesthesia problems, organ injury during surgery, and need for a larger laparotomy incision during surgery.

Although fewer problems occur with laparoscopy than with other kinds of tubal ligation surgery, these complications can be more serious. For example, in rare cases, the bowel or bladder is injured when the laparoscope is inserted.

The general risks of surgery are greater if you have diabetes, are overweight, smoke, or have a heart condition.

If a tubal ligation fails and you become pregnant, you have an increased risk of having an ectopic pregnancy.

After tubal ligation or salpingectomy: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have chest pain, are short of breath, or you cough up blood.

Call your doctor now or seek immediate medical care if:

  • You have pain that does not get better when you take your pain medicine.
  • You cannot pass stools or gas.
  • You have bright red vaginal bleeding that soaks one or more pads in an hour, or you have large clots.
  • You are sick to your stomach or cannot drink fluids.
  • You have vaginal discharge that has increased in amount or smells bad.
  • You have loose stitches, or your incision comes open.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • A fever.
  • You have signs of a blood clot in your leg (called a deep vein thrombosis), such as:
    • Pain in the calf, back of the knee, thigh, or groin.
    • Swelling in the leg or groin.
    • A color change on the leg or groin. The skin may be reddish or purplish, depending on your usual skin color.
  • Bright red blood has soaked through the bandage over your incision.

Watch closely for any changes in your health, and be sure to contact your doctor if you have any problems.

What can you expect as you recover from tubal ligation surgery?

After a tubal ligation, you will most likely go home the same day. Your surgeon will give you instructions about what to expect and when to call after the surgery.

  • You may have some slight vaginal bleeding caused by the movement of your uterus during the surgery.
  • If you had a laparoscopy, your stomach may be swollen (distended) from the air that was used to lift your skin and muscles away from your abdominal organs so the surgeon could see them better. This should go away within a day or so, but it may last longer. You may also have some back or shoulder pain from the air in your belly. This will go away as your body absorbs the air.
  • You can shower 24 hours after the surgery. But avoid rubbing or pulling on your incision for at least a week.
  • You can have sexual intercourse as soon as you feel like it and it doesn't cause pain. This is usually 1 week after surgery.
  • Be sure to rest for a few days (or at least 24 hours) before you start to resume your normal activities. You should be able to resume all activities within a week.
  • No backup method of birth control is needed after the surgery.

A follow-up exam in 2 weeks is usually scheduled.

Tubal Ligation: Returning Home

What happens on the day of your tubal ligation surgery?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
  • The surgery will take about 20 to 30 minutes.

Tubal Ligation Methods

Picture of ligation methods for female sterilization

Tubal ligation can be done by one of three different methods:

  • Pinching off the tube in a loop with a band
  • Cutting and electrocauterizing (burning) the tube ends
  • Cutting and tying off the tube ends

©2011-2024 Healthwise, Incorporated

The content above contains general health information provided by Healthwise, Incorporated, and reviewed by its medical experts. This content should not replace the advice of your healthcare provider. Not all treatments or services described are offered as services by us. For recommended treatments, please consult your healthcare provider.