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.
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.
Pinhole surgery is an alternative to open method for reversal. The only disadvantage of this method is that it takes times to be mastered. The good thing about it is that it is of short duration and does not invade the tissues too much. The patient is put to sleep through anaesthesia to ensure they are not traumatized by the 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.
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 these complications can be minimized by observing certain measures including administration of prophylactic antibiotics and observing sterility when handling the internal environment of the body. In addition, blood tests should be done before the operation to ensure the hemoglobin levels are within normal to cater for blood loss during surgery.
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.
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.
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.
Pinhole surgery is an alternative to open method for reversal. The only disadvantage of this method is that it takes times to be mastered. The good thing about it is that it is of short duration and does not invade the tissues too much. The patient is put to sleep through anaesthesia to ensure they are not traumatized by the 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.
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 these complications can be minimized by observing certain measures including administration of prophylactic antibiotics and observing sterility when handling the internal environment of the body. In addition, blood tests should be done before the operation to ensure the hemoglobin levels are within normal to cater for blood loss during surgery.
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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