Tubal Reversal Blog ‘female sterilization’

Tubal Sterilization Methods

‘Tying tubes’ is a phrase that is commonly used to refer to surgical procedures that result in tubal sterilization.

There are many different ways to block the fallopian tubes for tubal sterilization: ligation and resection (tying and cutting), tubal clips or rings, and electrocoagulation (burning). No matter how the procedure is done, the end result is closure or occlusion of the fallopian tube. This prevents sperm from reaching an egg.

Tubal Ligation and Resection

The most common female sterilization procedure is the ligation and resection method. This was the earliest reported method of sterilization, and it is still a very common and effective procedure. According to the method described by Dr. Ralph Pomeroy, an absorbable suture is tied around a “knuckle” of the fallopian tube that has been elevated and a segment is resected (cut out). The cut ends close as the tube heals. As the suture dissolves, the two tubal segments pull apart. Ligation and resection is currently the most popular form of sterilization for women. It is often performed during a cesarean delivery (C-section) or following a normal delivery.

Untying ‘Tied’ Tubes

A common misconception is that fertility can be restored by simply ‘untying’ the tubes. Tubal ligation reversal is not that simple. Tubal ligation and resection is reversed by opening the closed ends of the tubes and joining the tubal segments back together in perfect alignment using microsurgical techniques. Approximately 70% of patients at Chapel Hill Tubal Reversal Center become pregnant after a reversal of a ligation and resection procedure.

Tubal Ligation and Resection Can Be Reversed

Many people believe tubal sterilization is permanent and irreversible. Although tubal ligation and resection sterilization is intended to be permanent, this procedure can be reversed. Chapel Hill Tubal Reversal Center is the medical facility that specializes in tubal ligation reversal. We are experts in reversing tubal ligations- or ‘untying’ tubes that have been ‘tied’!

Submitted by Dr. Charles Monteith

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.

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).

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

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