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.
Following history taking is physical examination to rule out any signs of infection or other condition that may impact negatively on reversal surgery. Blood tests and imaging relevant to the case in question are also carried out. Typically, ultrasound is done to examine the status of the reproductive system and whether the tubes can be salvaged.
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.
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.
Complications of ligation reversal surgery are bound to happen, just like in any other surgical procedure. During the intra operative period, the patient may bleed excessively. Apart from bleeding, damage to surrounding structures is also a possibility. Infection may come later on during the recovery period. Formation of scar tissue is another bother as it may result in tubes getting blocked again. The chances of getting ectopic pregnancies after reversal are very high.
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 summary, it should be stated that tubal ligation is not necessarily permanent. It can be reversed by removing the rings or clips along the tube. Laparoscopy or open surgery are the two main surgical options. Age is a major contributory factor in the success of the intervention. Those above the age of forty stand a smaller chance of success.
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.
Following history taking is physical examination to rule out any signs of infection or other condition that may impact negatively on reversal surgery. Blood tests and imaging relevant to the case in question are also carried out. Typically, ultrasound is done to examine the status of the reproductive system and whether the tubes can be salvaged.
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.
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.
Complications of ligation reversal surgery are bound to happen, just like in any other surgical procedure. During the intra operative period, the patient may bleed excessively. Apart from bleeding, damage to surrounding structures is also a possibility. Infection may come later on during the recovery period. Formation of scar tissue is another bother as it may result in tubes getting blocked again. The chances of getting ectopic pregnancies after reversal are very high.
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 summary, it should be stated that tubal ligation is not necessarily permanent. It can be reversed by removing the rings or clips along the tube. Laparoscopy or open surgery are the two main surgical options. Age is a major contributory factor in the success of the intervention. Those above the age of forty stand a smaller chance of success.
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