TUBAL LIGATION - Tubal ligation is a surgical procedure for sterilization  Results in increased sexual enjoyment---no need to worry about

in which a woman's fallopian tubes are cut, tied, and burned. pregnancy
 No effect on breastfeeding
Goal: To preventeggs from traveling from the
 No known long-term side effects or health risks
ovaries to the uterus, thus, pregnancy is prevented
 Can be performed immediately after delivery
WHAT IS BTL
---RH LAW--- DISADVANTAGES
‣ A safe and simple surgical procedure which provides permanent  Requires minor surgery by a specially trained physician
contraception for women who do not want any more children  Requires an operating room set-up
‣Involves cutting or blocking the 2 fallopian tubes  Considered to be permanent
 Does not protect against STIs and HIV
MECHANISM OF ACTION  Limitation of physical activities for about 1 week
NO FERTILIZATION OCCURS POSSIBLE SIDE EFFECTS
The fallopian tubes that carry the eggs from the ovaries are cut off and Related to surgical procedure:
blocked. Eggs released from the ovaries cannot move down the
fallopian tubes to meet the sperm. ‣ Pain and swelling over the operative site (diminish in a day or two).

EFFECTIVENESS ‣ Superficial bleeding

‣ 99.5% effective (varies with the type) TIMINGOF BTL

‣ Varies slightly depending on how the tubes are blocked, but pregnancy Post-partum
rates are still low with all techniques. ‣ Immediately or within 7 days after giving birth
ADVANTAGES Interval
 Permanent method for contraception ‣ From 6 weeks after childbirth if it is reasonably certain that the
 Nothing to remember, no supplies needed, and no repeated woman is not pregnant
clinic visits required
 Does not interfere with sex ‣ Within 7 days after the start of the woman’s menstrual cycle
 Does not affect a woman’s ability to have sex
 ‣ At any time if it is reasonably certain that the woman is ‣ The ends of the fallopian tubes are connected to
not pregnant
‣ The back of the uterus and the connective tissue respectively.
Post-abortion
‣ pregnancy rate of around 70% on average.
‣ Within 48 hours after an uncomplicated abortion
Tubal Clip
WARNING SIGNS
‣ The Tubal Clip or Hulka Clip technique involves the application
 Bleeding, pain, pus, heat, swelling or redness of the wound that of a permanent clip onto the fallopian tube.
becomes worse or does not go away.
‣ Once applied and fastened, the clip disallows transference of
 High grade fever
eggs to the ovary.
 Fainting, persistent light-headedness, or extreme dizziness in the
first week ‣ Reversal and pregnancy success is best with this procedure
 Missed period
> 85% effective
Pomeroy Tubal Ligation
TYPES OF TUBAL LIGATION
‣ A loop of tube is “strangled” with a suture. The loop is cut, and the ends
Essure
cauterized or “burned.
-There are two small metal and fiber coils placed in the
‣ This type of tubal ligation is often referred to as cut, tied, and burned.
fallopian tubes.
TYPES OF TUBAL LIGATION
Note: A scar tissue forms around the coils after the
Pomeroy Tubal Ligation insertion, blocking off the fallopian tubes and preventing
sperm from reaching the egg.
‣ It considered a choice for reversal.
‣ A permanent method done as a laparoscopic procedure under
Irving Procedure
anesthesia
‣ This procedure calls for placing two ligatures
Adiana
(sutures) around the fallopian tube and removing the
segment of tubing between the ligatures.
‣ There are two small silicone pieces that are placed in the fallopian ‣ It involves tying two non-absorbable ligatures around the middle
tubes. The OB-GYNE heats a small portion of each fallopian tube and then portion of the fallopian tubes and then cutting out the tubal segment
inserts a tiny piece of silicone into each tube. between the two ligatures.

‣ scar tissue forms around the silicone inserts, blocking off the fallopian ‣ This procedure is very successful to reverse
tubes and preventing sperm from reaching the egg.
AFTER TUBAL LIGATION…
Bipolar Coagulation
Reversal Method
‣ The most popular method of laparoscopic female
‣ Reversing a Tubal ligation increases the likelihood of an ECTOPIC
sterilization, this method uses electrical current to
PREGNANCY.
cauterize sections of the fallopian tube.

‣ Depending on the number of sites coagulated, tube damage is typically

only 2 or 3 centimeters in length.

‣ Pregnancy rates after reversing this procedure are about 70%. IN SUMMARY…
Fimbriectomy ‣ Philippine Reproductive Health Law considered tubal
ligation as a permanent method of family planning.
‣ It involves removal of
a portion of the ‣ Tubal ligation uses suture, cautery, and clip.
fallopian tube closest to
the ovary, fimbriectomy ‣ The most common complication of reversing the method is ectopic
eliminates the ovary’s pregnancy.
ability to capture eggs ‣ Safe for all women, has no long-term side effects.
and transfer them to the ovary.
‣ No need to worry about contraception again.
‣ Reversing this procedure involves opening the remaining fallopian tube
and folding out the inner tubal lining so that egg capture is again possible. ‣ Is easy to use, nothing to do or remember.

Parkland Method ‣ The procedure is intended to be permanent.