Reversal of sterilisation is carried out using microsurgical techniques. This involves excision of the damaged section of the tube and then reconnecting two ends of the fallopian tube together. The advantage of tubal reversal surgery is that a baby should be able to be conceived naturally following the treatment.
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Reversal of sterilisation is most successful in women who had filshie clips applied at the time of their sterilisation. The application of filshie clip causes minimal damage to the tube and usually does not adversely affect the length of the fallopian tube which has been damaged. Reversals of other sterilisation techniques, such as Pomeroy (a small part of the fallopian tube is excised) are not as successful.
There are some factors which affects success rates:
- A woman’s age
- Condition of the fallopian tubes (any exposure to STI since sterilisation has been carried out)
- Fertility potential of the female as checked by hormones estimation
- Fertility of male partner
The procedure is carried out under general anaesthesia through a small incision which is made along the bikini line. It usually takes about one to one and a half hours. The surgery is carried out under magnifying lenses or a microscope where both obstructed ends of the fallopian tubes are excised. The patency of both segments of the fallopian tubes are checked before approximating them using very fine suture material. Following surgery patency of the fallopian tubes is again re-confirmed.
Occasionally it is only feasible to do the operation to one tube as the other tube may be damaged.
The skin is closed either with sutures or metal clips are applied which are removed on the fifth day of recovery. You can usually go back to normal activities within a month.
During the operation you will be given a course of antibiotics to minimise the risk of infection and you will also be prescribed with a special injection to minimise risk of developing a clot in the legs.
Possible complications at the time of operation
Your doctor will explain to you possible complications related to the surgical procedure, mainly bruising around the wound, which is common and does not require any treatment. Occasionally infection can occur in the wound and you may need antibiotics.
If you miss a period and think you may be pregnant, please perform a pregnancy test. When you are about two weeks past missing your period, you will need an ultrasound scan to make sure that the pregnancy is in the womb. Available evidence suggests that the risk of ectopic pregnancy is increased following reversal of tubal occlusion. Overall the success rate of sterilisation reversal is between 50-60%.
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The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.