What is Tubal Ligation Reversal

Tubal ligation reversal is a procedure to undo a tubal ligation so that the woman can get pregnant again. Tubal ligation is a procedure to close the fallopian tubes so a woman cannot get pregnant. During this procedure, the fallopian tubes are reopened, untied, or reconnected to separated sections.

The ability to get pregnant again after having this procedure depends on:

• Your age.
• The type of tubal ligation that you had.
• The length of your remaining fallopian tubes.
• How healthy the tubes are.
• The amount of scar tissue in your pelvic area.
• Your partner’s fertility.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Any past pregnancies.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Failure to reverse the original procedure.
• Future blockage of a reopened or reconnected fallopian tube.
• Inability to get pregnant.
• Ectopic pregnancy. This is a pregnancy in which a fertilized egg does not attach inside the uterus.
• Infection.
• Bleeding.
• Damage to other structures or organs.
• Blood clots in the legs and chest.
• Allergic reactions to medicines.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

General instructions

• You and your partner may need to have a physical exam and blood and imaging tests to make sure that you do not have any unknown fertility problems.
• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you take diabetes medicines or blood thinners.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
• Plan to have someone take you home after the procedure.
• If you go home right after the procedure, plan to have someone with you for 24 hours.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Hair may be removed from the surgical area.
  • Your skin will be washed with soap.
• An IV will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine that is injected into an area of your body that numbs everything below the injection site (regional anesthetic).
  • A medicine that numbs the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
• A tube may be put down your throat to help you breathe.
• Your bladder may be emptied with a small, thin tube (catheter).
• Small cuts (incisions) will be made in your abdomen.
• Your abdomen will be inflated with a gas. This will give the surgeon room to work and enable him or her to see your organs clearly.
• A thin, lighted tube with a camera (laparoscope) will be inserted through an incision into the pelvic area. Small instruments will be inserted through the other incision.
• Any clips, rings, or clamps that were used to close your fallopian tubes will be removed, and any unconnected sections of your fallopian tubes will be reconnected.
• Your fallopian tubes will be tested to make sure that they are open.
• The incisions will be closed with stitches (sutures).
• A bandage (dressing) will be placed over the incisions.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• You will be given medicine for pain, nausea, or vomiting as needed.
• You will be encouraged to walk as soon as possible.
• Do not drive for 24 hours if you received a sedative.

Summary

• Tubal ligation reversal is a procedure to undo a tubal ligation so that a woman can get pregnant again.
• During this procedure, the fallopian tubes are reopened, untied, or reconnected to separated sections.
• Follow instructions from your health care provider about eating and drinking before the procedure.

Tubal Ligation Reversal, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Mild abdominal discomfort. This can include:
  • Mild cramping.
  • Gas pains or feeling bloated.
  • Pain or soreness at the incision areas.
• Discomfort in the shoulder area. This is caused by air that is trapped between your liver and your diaphragm. The discomfort will slowly go away on its own.
• Tiredness.
• A sore throat if you had a breathing tube.
• Nausea or vomiting.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not take aspirin because it can cause bleeding.
• Do not drive or use heavy machinery while taking prescription pain medicine.

Activity

• Rest as told by your health care provider. Gradually return to your normal activities as told by your health care provider.
• Avoid sitting for a long time without moving. Get up and move around one or more times every few hours.
• Do not douche, use tampons, or have sexual intercourse for an entire menstrual cycle, or as told by your health care provider.
• Do not lift anything that is heavier than 10 lb (4.5 kg), or as told by your health care provider.
• Have someone help you with your daily household tasks for the first 7–10 days, or as recommended by your health care provider.

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges.
• Do not take baths, swim, or use a hot tub until your health care provider approves. You may take showers.
• Check your incision area every day for signs of infection. Check for:
  • Redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.

General instructions

• To prevent or treat constipation while you are taking prescription pain medicine, your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Take over-the-counter or prescription medicines.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried and sweet foods.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay healing. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important. You will need to have a follow-up X-ray dye test about 3–4 months after the surgery to make sure that your tubes are open.

Contact a health care provider if:

• You have signs of infection, such as:
  • Redness, swelling, or pain around your incision sites.
  • Fluid or blood coming from an incision.
  • An incision that feels warm to the touch.
  • Pus or a bad smell coming from an incision.
• Your incision breaks open.
• You have a fever.
• You have a rash.
• You feel dizzy or lightheaded.
• You cannot eat or drink without vomiting.
• You are constipated.

Get help right away if:

• You have shortness of breath or difficulty breathing.
• You have chest or leg pain.
• You repeatedly feel lightheaded.
• You faint.
• You have increasing pain in your abdomen.
• You feel a burning sensation or pain when you urinate.
• You have heavy vaginal bleeding when it is not time for your menstrual period.

Summary

• It is common to have a sore throat, mild abdominal pain, and fatigue after the procedure.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important. You will need to have a follow-up X-ray dye test about 3–4 months after the surgery to make sure that your tubes are open.