Tubectomy is the procedure of cutting or closing the fallopian tubes or ovaries that connect the ovaries to the uterus. After tubectomy, the egg cells will not be able to enter the uterus so they cannot be fertilized. This procedure will also prevent sperm from entering the fallopian tube.
As a permanent birth control method, tubectomy has proven to be very effective, but it does not affect the menstrual cycle. This process can be done at any time, including after undergoing normal labor and caesarean delivery.
Tubectomy Indications
Tubectomy is one of the permanent methods to prevent pregnancy. Therefore, this procedure is only recommended for adult women who truly believe that they do not want to get pregnant.
This process can also reduce the risk of ovarian cancer, especially in women over the age of 40, or who have a family history of ovarian cancer.
Tubectomy Warning
There are a number of factors that should be considered before a woman undergoes tubectomy. Some of them are:
- Benefits and risks. Discuss the benefits as well as the risks of this procedure with the doctor with your spouse or immediate family so that there are no regrets.
- Certain conditions. Inform your doctor if there are certain conditions that need to be considered, for example whether the patient is pregnant or not, drugs or supplements that are being used, illnesses, use of illegal drugs, or alcohol consumption.
- Use of contraception. If tubectomy is performed outside of labor, use contraception at least 1 month before tubectomy. This step is done to prevent pregnancy.
Pre Tubectomy
Before undergoing tubectomy, the doctor will ask the patient to take certain steps so that the operation can run smoothly while minimizing the risk of complications.
A few days before surgery
- Stop taking drugs that have the potential to block blood clots. For example ibuprofen, aspirin, or warfarin.
- Stop smoking, consuming alcohol, or using illegal drugs.
- Patients who will undergo a fallopian tube blockage procedure, or selective tubal occlusive procedure (STOP), are advised to use hormone drugs for at least 2 weeks.
On the day of the surgery
- Fast for at least 8 hours before surgery.
- Take a pregnancy test to make sure the patient is not pregnant.
Tubectomy Procedure
Tubectomy can be done with local or general anesthesia (total). This type of anesthesia will be determined by the doctor based on the patient's condition and the type of surgery underwent.
Tubectomy can be done in conjunction with a Caesarean section. However, if it is performed outside of a Caesarean section, there are 2 types of tubectomy procedures to choose from, namely laparoscopy and minilaparotomy.
Laparoscopy
This method is most commonly chosen because the procedure and recovery period are relatively fast. The procedure includes:
- Make 1 or 2 small incisions near the navel.
- Pumping gas into the stomach so that the fallopian tubes and uterus are clearly visible.
- Insert a laparoscope (miniature camera tube) into the abdomen to see the fallopian tubes.
- Insert a device to close or cut the fallopian tube through a laparoscope or other small incision.
- Burn or clog the fallopian tubes.
- Take out the laparoscope and other tools, then sew the incision.
Minilaparotomy
This method is done through a small incision under the navel and is recommended for patients who are obese, have undergone stomach or pelvic surgery, and have had pelvic infections that affect the uterus or fallopian tubes.
In addition to surgery, tubectomy can be done with a hysteroscopic procedure. This method is carried out through the cervix so that it does not require surgery and rarely requires anesthesia.
Post Tubectomy
After undergoing tubectomy, patients with general anesthesia are advised to stay overnight in the hospital. While patients undergoing local anesthesia can go home the same day after 1 to 4 hours after surgery.
Like all surgeries, tubectomy also has the potential to trigger side effects. Some of these include pain in surgical wounds, feeling tired, dizzy, abdominal pain or cramps, shoulder pain, and flatulence. The doctor will give pain medication to overcome them.
There are also a number of things to keep in mind during the patient's recovery from post-surgery. Some of them are:
Keep the scar from being exposed to water for 2 days, as well as not rubbing the wound for at least 7 days after surgery.
- Carefully dry the surgical scar.
- Avoid lifting heavy loads for 3 weeks, for example holding a child.
- Not doing strenuous activities or sex for at least 1-2 weeks, and doing activities gradually.
- For patients who undergo a fallopian tube blockage procedure (tubal occlusive procedure), it is recommended to continue using contraception for 3 months after the procedure.
If side effects do not go away or there are alarming indications, the patient should immediately see a doctor. Especially if you experience:
- Fainting repeatedly.
- Fever.
- Severe abdominal pain or bleeding in the surgical wound that does not go away in 12 hours after surgery.
- Continual discharge from the surgical wound.
Possible complications after tubectomy
Most women who undergo tubectomy can return to their daily activities without complications. Examples of complications that might result from this surgery are:
- Disorders or injuries to the intestines, bladder and main blood vessels.
- Continuous pelvic or abdominal pain.
- Infection of the surgical wound.
Tubectomy is also not able to protect a woman from sexually transmitted diseases. Therefore, keep using a condom if you doubt the health of your partner or you have more than 1 partner.
The chances of getting pregnant after this surgery are very small. If it does, there is a high possibility that it is an ectopic pregnancy. Therefore, immediately do a pregnancy test if your menstruation is late.
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