Can burned tubes be repaired with any degree of success?
Tubal coagulation is a common method of tubal ligation. Tubal coagulation is the medical term for the most common method of tubal ligation which is more commonly known as ‘burning’.
Many women are unaware of the exact method their doctors used to perform their tubal ligation procedure. When these women begin to consider reversal surgery they will often look through their records and see the procedure on the tubal ligation operative report listed as ‘tubal coagulation’. They usually have no idea what this means until they Google the term or ask their doctor.
Tubal coagulation simple means the doctor burned the fallopian tubes using electricity.
Although having ‘tubal burning’, ‘burnt tubes’, or ‘burned and cut tubes’ sounds bad, most of these tubal ligation methods are reversible. Not only are these methods reversible, but there is a good chance to becoming pregnant.
Tubal coagulation is not always bad. In general, most can be reversed and the chance of pregnancy after reversal could be as high as 60%.
Types of tubal coagulation
There are only two types of tubal coagulation: bipolar and monopolar.
Both methods are performed six (6) weeks of more after giving birth. These methods are not used during C-sections or within the first 48 hours of a having a vaginal birth.
Tubal coagulation procedures are done using a small camera inserted through the belly button (laparoscopic surgery also sometimes referred to as camera surgery or key hole surgery). During the procedure the doctor makes a small incision inside the deep part of the belly button. Through this small incision the doctor inserts a camera (laparoscope) into the abdomen to look at the tubes. Sometimes the doctors can insert both a camera and a small instrument to burn your tubes through the single belly button. Sometimes doctors will make a second small incision above the pubic hair area. They will insert the camera through the belly button incision and insert the burning instrument through the second incision.
The burning instrument can be a bipolar instrument or a monopolar instrument. The bipolar method is by far the most common type and this instrument is usually called a ‘Bipolar device’ or a ‘Kleppinger’ device.
Bipolar fallopian tube coagulation
Bipolar tubal coagulation is the most popular and common method of laparoscopic tubal ligation in the United States.
Bipolar coagulation
With this method of tubal ligation, the fallopian tube is grasped with a small instrument and electrical current is used to coagulate, or burn, the tube in a small area, but only in the area where the tube is being grasped.
During the coagulation procedure, the electric current passes between the two arms grasping instrument. The only part of the tube damaged is the small area between the of the grasping instrument. Often, two or three adjacent sites on the fallopian tube are coagulated to further guarantee the tube will heal closed.
The bipolar instrument is the least damaging of the coagulation methods because the electricity only burns a small part (usually) of the Fallopian tube.
Bipolar tubal coagulation can be reversed and pregnancy rates after reversal of bipolar tubal coagulation are approximately 66%.
Monopolar fallopian tube coagulation
Monopolar coagulation of the fallopian tubes is less common than bipolar coagulation tubal ligation.
Monopolar coagulation
During monopolar coagulation a different type of grasping instrument is used and the electrical current spreads outward from the coagulating instrument. Monopolar coagulation can be more destructive to the fallopian tube than bipolar coagulation because of the spreading nature of the electrical current.
A monopolar device usually ‘zaps’ the fallopian tube with a spark of electricity. This electricity can be very damaging and can travel down the tube for a greater distance than electricity used during bipolar coagulation.
The complication rates of monopolar coagulation can be higher. There have been cases where other organs have been damaged during these types of tubal ligation procedures and this is one reason why monopolar coagulation is not as common as bipolar coagulation.
When a single site of the tube has been coagulated and divided during monopolar coagulation, tubal reversal can be performed without difficulty.
Pregnancy rates after reversal of monopolar coagulation procedures are approximately 40-50%.
Is having coagulated tubes bad?
Naturally many women think having coagulated tubes is bad and tubal burning is not a good method to reverse. Sometimes this is true but most times burned tubes can be repaired.
The red circle around the white area shows the burned portion of the fallopian tube
The method used during the tubal ligation is not as important as HOW MUCH damage was done. The reversibility of these types of tubal ligation depend not so much on the method…but more on the doctor. This is where the problem comes in.
Some doctors burn a little but some doctors burn a lot. Some doctors may burn one very small section of the fallopian tube (very reversible) and some doctors may burn the entire tube on each side.
The most common amount of tube to be burned is usually described in the operative note as the ‘3 point’ burn or sometimes they will say they burned 3 centimeters of each tube. This amount of burning is very reversible with good results.
Can burned tubes be repaired?
Often what is done to the tubes is not as important as how much of it was done to the fallopian tubes.
The amount of tubal coagulation is more dependent on the technique of the doctor than some other ligation methods (i.e. tubal clips and tubal rings) and each doctor may perform tubal coagulation differently.
If you are wondering if your burned tubes can be repaired and if you are a candidate for tubal ligation reversal then the best way to tell is to get a copy of your tubal ligation operative report.
The tubal ligation operative report describes exactly what was done during your tubal ligation procedure. This report can usually be obtained from the Medical Records department where your surgery was performed.
Dr. Monteith is the Medical Director of A Personal Choice Tubal Reversal Center in Raleigh North Carolina. He specializes in reversing all types of tubal ligation and he does have considerable success in reversing coagulated fallopian tubes.
If you would like to see if you are a candidate for reversal then you should send him your tubal ligation operative report for a free review.
The following video explains how to obtain your operative note and send it to Dr. Monteith for a free review.
Dr. Monteith allows women to directly upload their tubal ligation operative reports to a HIPAA compliant medical records portal on his website. He will review these records at no charge and tell potential patients if they are candidates for reversal surgery.
More information: How to send reports to Dr. Monteith for a free review?
Having burned tubes is not always as bad as it sounds and most burned tubes can be repaired.
In our experience most tubal coagulation procedures can be reversed and approximately 66% of our patients will report pregnancy after reversal of burned tubes.
