Tubal Ligation Reversal Blog

Untying tied tubes: Hulka clips

Hulka Clip Sterilization

One common form of female sterilization is the use of Hulka clips to block the fallopian tubes. The Hulka clip was approved for use in the United States in the 1970′s and was invented in Chapel Hill, North Carolina by Dr. Jaroslav Hulka at the University of North Carolina at Chapel Hill.

Hulka clip in the laparoscopic applicator.The Hulka clip is a small, gold plated stainless steel spring loaded clip. The clip in introduced into the abdominal cavity via a laparoscopic clip applicator. This image shows the open clip in the applicator and the tip of the laparoscope with its fiber optic lighted end. When the clip is placed across the fallopian tube, it is closed and a small spring holds the clip firmly across the tube. The Hulka clip has the advantage of damaging only a very small portion of the fallopian tube- approximately 7mm (the thickness of three quarters stacked on each other).

Hulka clip closed across the fallopian tube.The Hulka clip causes bilateral tubal occlusion by squeezing a very small portion of the tube. The squeezed portion is deprived of its blood supply and eventually undergoes avascular necrosis (dies and is absorbed by the body). This causes the fallopian tube to be divided in half and the two ends to close up. The Hulka clip is held in place between the two divided tubal segments by a small amount of scar tissue which forms within the clip.

Hulka Clip Reversal

A common misconception is that the Hulka clips can simply be opened to reverse the sterilization process – that the tubes can be unclipped. Unfortunately, tubal ligation reversal for Hulka clips is not as simple as opening the clips. Hulka clip tubal occlusion is reversed by removing the section of the tube with the clip across it and then, using microsurgical techniques, joining the remaining tube segments back together in perfect alignment.

Tubal reversal of Hulka clip tubal occlusion is better than for most other methods of sterilization because such a minimal amount of tube is destroyed in the occlusion process. Approximately 76% of patients at Chapel Hill Tubal Reversal Center become pregnant after a reversal of a Hulka clip sterilization procedure.

Common Misconception About Tied Tubes

Tying tubes like tying a shoe lace.Many patients seem to imagine the fallopian tube is like a shoe lace which is tied up like a bow to prevent pregnancy. As tubal ligation reversal specialists, we wish it were that easy- then untying tied tubes would be easier!

‘Tying ones fallopian tubes’ is a common language phrase used to describe several different surgical procedures which result in sterilization (a procedure intended to permanently prevent pregnancy). The more correct medical term is bilateral (both sides) tubal occlusion (closure of the fallopian tube).

There are many different ways to occlude (close) the fallopian tubes: ligation and resection (tying and cutting), clips and rings, and coagulation (burning). No matter how the procedure is done the end result causes the tube to close, heal shut, and prevent sperm from fertilizing an egg.

Tubal Sterilization is Reversible

Many people believe tubal sterilization is permanent and irreversible. Although Hulka clip sterilization is intended to be permanent, this procedure is ideal for tubal reversal. The Chapel Hill Tubal Reversal Center is the one medical facility which specializes in tubal ligation reversal.

We have become experts in reversing all types of tubal ligations- or ‘untying’ tubes that have been ‘tied’!

Submitted by Dr. Charles Monteith

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38 thoughts on “Untying tied tubes: Hulka clips

  1. Dr. Monteith Post author

    We have many patients who come to us from Iowa because we only charge $5900 for the surgery and this is a much lower cost than if they had the surgery in their area. Often patients can not find doctors who have significant enough experience in their home towns to perform the surgery with either skill or low cost in mind. I will email you additional information.

  2. Robin

    I live in Iowa. I got the Hulka clips done about 11yrs ago. I need to learn about a close location and the cost of getting reversed.

  3. Dr. Monteith Post author

    It is not too late for you to try to become pregnant. If you are having regular periods then pregnancy is always possible after reversal. The chance of pregnancy after age 40 among our patients is approximately 40%.

  4. Cynthia

    I got Hulka Clips when i was 21 after having 2 kids. I’m now 7 years with my husband and he has no kids and i will be 40 this year, he has no kids and is 35. Is it to late for me to try??

  5. Wendy Ruiz

    I’m not exactly sure what kind of tubal I had. I know they went through my belly button after I had my third child. As in the case of Desiree, I was forced by my now ex-husband to have it done. I am also now remarried and my husband and I want to have a baby. My tubal was done 19yrs ago. I would like to find out some information about the procedure to reverse. At this moment I have’nt had a period for 2 months. I’m going to do a pregnancy test. But I would like information. Thank you.

  6. Desiree

    I had the Hulka clips since I was 23, forced to get fixed at young age by my now ex husband. 10 years later, I am now happily remarried and we both want to have children. I live in a WI and dont know where the closest place is to get this reversed. Where and how much would this be and is it possible for me to get pregnant again?

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