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Tubal ligation reversal

Tubal re-anastomosis surgery; Tuboplasty

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Description

Tubal ligation reversal is surgery done to allow a woman who has had her tubes tied (tubal ligation) to become pregnant again. The fallopian tubes are reconnected in this reversal surgery. A tubal ligation cannot always be reversed if there is too little tube left or if it is damaged.

Why the Procedure Is Performed

Tubal ligation reversal surgery is done to allow a woman who has had her tubes tied to become pregnant. However, the surgery is rarely done any more. This is because the success rates with in vitro fertilization (IVF) have risen. Women who wish to become pregnant after having tubal ligation, are most often counselled to try IVF instead of surgical reversal. Also, some tubal ligations are now performed by removing the entire tube for sterilization leaving no possibility of reversal.

Insurance plans often do not pay for this surgery.

Risks

Risks for anesthesia and surgery are:

• Bleeding or infection
• Damage to other organs (bowel or urinary systems) may need more surgery to repair
• Allergic reactions to medicines
• Breathing problems or pneumonia
• Heart problems

Risks for tubal ligation reversal are:

• Even when surgery reconnects the tubes, the woman may not become pregnant.
• A 2% to 7% chance of a tubal (ectopic) pregnancy.
• Injury to nearby organs or tissues from surgical instruments.

Before the Procedure

Always tell your surgeon what medicines you are taking, even medicines, herbs, or supplements you bought without a prescription.

During the days before your surgery:

• You may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), warfarin (Coumadin), and any other medicines that make it hard for your blood to clot.
• Ask your surgeon which medicines you should still take on the day of your surgery.
• If you smoke, try to stop. Ask provider for help quitting.

On the day of your surgery:

• You will most often be asked not to drink or eat anything after midnight the night before your surgery, or 8 hours before the time of your surgery.
• Take the medicines your surgeon told you to take with a small sip of water.
• Your surgeon will tell you when to arrive at the hospital or clinic.

After the Procedure

You will probably go home the same day you have the procedure. Some women may need to stay in the hospital overnight. You will need a ride home.

It may take a week or more to recover from this surgery. You will have some tenderness and pain. Your surgeon will give you a prescription for pain medicine or tell you which over-the-counter pain medicine you can take.

Many women will have shoulder pain for a few days. This is caused by the gas used in the abdomen to help your surgeon see better during the procedure. You can relieve the gas by lying down.

You may shower 48 hours after the procedure. Pat the incision dry with a towel. DO NOT rub the incision or strain for 1 week. The stitches will dissolve over time.

Your surgeon will tell you how long to avoid heavy lifting and sex after the surgery. Return to normal activities slowly as you feel better. See your surgeon 1 week after surgery to make sure healing is going well.

Outlook (Prognosis)

Most women have no problems with the surgery itself.

A range from 30% to 50% up to 70% to 80% of women may become pregnant. Whether a woman becomes pregnant after this surgery may depend on:

• Her age
• The presence of scar tissue in the pelvis
• The method used when tubal ligation was done
• The length of the fallopian tube that is rejoined
• The skill of the surgeon

Most pregnancies after this procedure occur within 1 to 2 years.

References

Feng Y, Zhao H, Xu H, et al. Analysis of pregnancy outcome after anastomosis of oviduct and its influencing factors. BMC Pregnancy Childbirth. 2019;19(1):393.PMID: 31666022 pubmed.ncbi.nlm.nih.gov/31666022/.

Godin PA, Syrios K, Rege G, Demir S, Charitidou E, Wery O. Laparoscopic reversal of tubal sterilization; a retrospective study over 135 cases. Front Surg. 2019;5:79. PMID: 30687715 pubmed.ncbi.nlm.nih.gov/30687715/.

Shahi M, Amarosa EJ, Crum CP. The fallopian tube and broad ligament. In: Crum CP, Nucci MR, Howitt BE Granter SR, Parast MM, Boyd TK, eds. Diagnostic Gynecologic and Obstetric Pathology. 3rd ed. Philadelphia, PA: Elsevier; 2018:chap 21.

Review Date: 8/23/2023  

Reviewed By: LaQuita Martinez, MD, Department of Obstetrics and Gynecology, Emory Johns Creek Hospital, Alpharetta, GA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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