Tubal Reversal Blog October, 2008

This article profiles a patient who came to Chapel Hill Tubal Reversal Center for reversing tubal ligation at which time she was found to have ovarian endometriosis.

Travel from California

The patient and her husband traveled from Monterrey, California for tubal ligation reversal. She is 44 years old and is a banker. She has two children from previous marriage, ages 12 and 15. Her husband is a meteorologist. He has two children from a previous marriage, ages 16 and 18. They moved from Texas to California and have been married together for 1 year and 3 months. Together, they desire a child of their own.

IVF Evaluation

Prior to traveling to visit us, they had a consultation with a reproductive endocrinologist near where they live. They expressed dissatisfaction with their consultation because they felt the doctor only wanted to offer them in-vitro fertilization (IVF). They did consider IVF but decided the procedure was not for them. During the preoperative consultation they specifically stated:

“We wanted to have a baby as God intended it.”

They did their own search for tubal reversal doctors and chose to come to Chapel Hill Tubal Reversal Center because we specialize exclusively in reversing tubal ligation. They felt their chance for a successful reversal procedure would be best at our center.

Preoperative Evaluation and Surgery

She was a healthy person and denied any known preexisting problems or menstrual abnormalities.  We reviewed her tubal ligation operative and pathology reports that described at least 3 cm removed from each fallopian tube. We discussed their expectations and the risks and benefits of tubal reparative surgery.

During her surgical procedure and upon entering the abdominal cavity, we discovered brown fluid suggesting the presence of endometriosis. Close inspection of the right ovary revealed endometriosis inside of it and partially involving the right tube.

We removed the endometriosis and repaired the right tube. The left tube and ovary were normal. The left tube was repaired without difficulty.

She did well during the surgery. In the recovery room, we informed her and her husband of the unexpected endometriosis and the successful repair of both fallopian tubes.

Endometriosis

Endometriosis can be suspected in most patients based on a careful evaluation of a menstrual history. Many women with endometriosis will have extremely painful menstrual periods. Menstruation can be so painful patients may require large amounts of pain medications, miss time from work, or will have pelvic pain which drastically affects their  personal lives. Many women give a history of severe pelvic pain, especially with intercourse and will plan their sexual activity based on their menstrual cycles. Many patients, like this one, can have minimal or no symptoms of endometriosis.

We could not have predicted this patient’s endometriosis in advance because of her absence of preexisting symptoms. Fortunately, we were able to successfully reverse her tubal ligation and remove the endometriosis at the same time.

We wish her well on her trip back to Monterrey California and hope a healthy pregnancy will be in her near future.

Katherine is planning to be a future reversal patient of Chapel Hill Tubal Reversal Center in the fall of 2008. She discovered us while searching the Internet.

Here Katharine tells her story in her own words…

My ligation was two years ago. A month later, while getting ready for a wedding, I destroyed my bathroom upstairs in my home!

My boyfriend was in total shock! He flew up the stairs to see what in the world was going on up there. I had a “fit of rage”. It was awful. It is still very embarrassing to talk about. I do not have a history of mental illness or mood disorders. This ‘fit’ was extremely terrifying for me and for my boyfriend. After calming myself enough to grab the phone, I called my gynecologist. It was a Saturday and the Doctor on call suggested I seek psychiatric help.

Still shaking, and holding the phone in my lap…I thought for a moment…”Maybe I am crazy.”
Needless to say I never made it to the wedding, as I was afraid that I might have another “episode”. A few months later…my boyfriend moved out because he never knew what kind of woman he would come home to. The sad part is I’d wake up and wonder what kind of woman I would be that day. My instinct told me the tubal ligation was the cause of my emotional instability. I just knew it. It was intuition.

I made an appointment with the Doctor who performed the ligation (Filshie clips). When my name was called, I was ushered into the Nurse’s office instead of my Doctor’s office. The nurse explained the Doctor heard I was there to talk about a reversal and wanted to relay to me he “does not do reversals and is not aware of any post ligation symptoms and that I should seek professional psychiatric help.” I left crying.

I then called a psychiatrist who put me on Depakote, Lamectil and Klonopin. I informed her I have Post Tubal Ligation Syndrome (PTLS) symptoms PTLS, but I think she feels I’m bi-polar. The medication does help with the violent mood swings and depression.

The main symptoms are:

daily headaches
2-week PMS
7-8 day HEAVY periods (pass clots the size of walnuts)
anxiety, panic attacks, depression
pitting edema in ankles
fits of rage
uncontrollable crying spells
during ovulation..I have to sit on a pillow while driving and can’t sit flat on my chair at work. Pain with walking
sharp pains in my right side
pain during and after sex (especially after…I curl up in ball and suffer)

I have a small 10-acre farm with horses, dogs, and cats and soon…pigs! I don’t have time to be a pain ridden Tasmanian devil. I love my job, my family, my farm and it is so hard to enjoy it all when PTLS rules my life. I feel all of this is about to change now that I have found Chapel Hill Tubal Reversal Center!

Most importantly…My boyfriend and I have started dating again after a year apart. I showed him all of the emails, websites, etc that explain why I am the way I am…

A complete discussion of Post Tubal Ligation Syndrome and the stories of other PTLS patients who have undergone tubal reversal can be seen in our blog series on PTLS. The first of fourteen articles is Pain After Tubal Ligation: A Symptom of Post Tubal Ligation Syndrome? .

Readers can also view other patient submitted stories about their menstrual symptoms, reasons for reversing tubal ligation, and outcomes after reversal reversal surgery. Each patient’s story is listed below:

Meet Momzilla
Meet Andrea
Meet Rebecca
Meet Praybelieving

We invite readers to join our Tubal Reversal Message board and discuss and share personal experiences with tubal ligation. We also have a dedicated PTLS forum for readers to share experiences of worsening symptoms after tubal ligation procedures.