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.
History, physical examination and investigations are necessary before the doctor decides that surgery can be undertaken. A good rapport should be created between the doctor and the patient so that relevant medical details can be revealed. Any past illnesses involving the genitourinary system should be documented. This could be infection, malignancy, congenital malformations and so on. Any operations done previously should also be taken in to consideration. Common operations that can interfered with reversal include myomectomy, cesarean section, management of an ectopic pregnancy and so on.
The doctor needs to do a focused physical examination to determine the stability of the patient for the planned operation. Certain investigations including blood tests and imaging studies are also required just as is the case with many other operations. The commonest imaging technique utilized is a pelvic ultrasound. A pelvic radiographic film with contrast enables the gynecologist to know the remaining size of oviducts and whether or not they can be modified to start working normally again.
Pinhole surgery is an alternative to open method for reversal. The only disadvantage of this method is that it takes times to be mastered. The good thing about it is that it is of short duration and does not invade the tissues too much. The patient is put to sleep through anaesthesia to ensure they are not traumatized by the procedure.
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.
Comparable to other surgeries, reversal surgery can complicated with excessive blood loss, neighbouring soft tissue injury and infection which may develop later on. In the long run, fibrous tissue may form causing obstruction again. Ectopic pregnancies are also much more among women who have had their tubes untied.
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 conclusion, there is room for reversal even after tubal ligation. The size of the remaining tubes determines whether the procedure will be successful or not. It is done by unclipping the area and suturing together the open ends. Women below the age of forty are more likely to get pregnant after the reversal operation.
History, physical examination and investigations are necessary before the doctor decides that surgery can be undertaken. A good rapport should be created between the doctor and the patient so that relevant medical details can be revealed. Any past illnesses involving the genitourinary system should be documented. This could be infection, malignancy, congenital malformations and so on. Any operations done previously should also be taken in to consideration. Common operations that can interfered with reversal include myomectomy, cesarean section, management of an ectopic pregnancy and so on.
The doctor needs to do a focused physical examination to determine the stability of the patient for the planned operation. Certain investigations including blood tests and imaging studies are also required just as is the case with many other operations. The commonest imaging technique utilized is a pelvic ultrasound. A pelvic radiographic film with contrast enables the gynecologist to know the remaining size of oviducts and whether or not they can be modified to start working normally again.
Pinhole surgery is an alternative to open method for reversal. The only disadvantage of this method is that it takes times to be mastered. The good thing about it is that it is of short duration and does not invade the tissues too much. The patient is put to sleep through anaesthesia to ensure they are not traumatized by the procedure.
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.
Comparable to other surgeries, reversal surgery can complicated with excessive blood loss, neighbouring soft tissue injury and infection which may develop later on. In the long run, fibrous tissue may form causing obstruction again. Ectopic pregnancies are also much more among women who have had their tubes untied.
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 conclusion, there is room for reversal even after tubal ligation. The size of the remaining tubes determines whether the procedure will be successful or not. It is done by unclipping the area and suturing together the open ends. Women below the age of forty are more likely to get pregnant after the reversal operation.
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