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.
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.
Surgery can be performed in two main ways; laparoscopic or open. Laparoscopy has the advantage of being both diagnostic and therapeutic. It also takes a shorter time to perform and is less invasive. The aim of surgery is to unclip the tied tubes and to reconnect the open ends. General anaesthesia is needed for this surgical procedure to occur without pain and muscle spasms.
One of the common factors that may render the operation useless is age. Women below the age of forty stand a better chance of conceiving than those above. A history past pelvic operations causes and increase in adhesion formation which may end up clogging the tube again. Moreover, couples with other underlying issues with their fertility have very little chance of success in pregnancy if these are not sorted out.
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.
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.
Surgery can be performed in two main ways; laparoscopic or open. Laparoscopy has the advantage of being both diagnostic and therapeutic. It also takes a shorter time to perform and is less invasive. The aim of surgery is to unclip the tied tubes and to reconnect the open ends. General anaesthesia is needed for this surgical procedure to occur without pain and muscle spasms.
One of the common factors that may render the operation useless is age. Women below the age of forty stand a better chance of conceiving than those above. A history past pelvic operations causes and increase in adhesion formation which may end up clogging the tube again. Moreover, couples with other underlying issues with their fertility have very little chance of success in pregnancy if these are not sorted out.
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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