Tubal Coagulation: Burned Tubes Can Be Repaired
Tubal coagulation is an extremely common method of tubal ligation. This method is also known as ‘tubal burning’.
Although having ‘tubal burning‘, ‘burnt tubes‘, or ‘burned and cut tubes‘ seems bad, our experience has demonstrated this method of tubal ligation is reversible and will provide our patients with a good chance at becoming pregnant after reversal.
Tubal coagulation procedures are often done using a small camera and instrument inserted through the belly button (laparoscopic surgery). There are two types of coagulation procedures: bipolar and monopolar. Bipolar is by far the most common type of tubal coagulation procedure performed in the United States.
Bipolar tubal coagulation is the most popular method of laparoscopic tubal ligation in the United States. 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.
Bipolar tubal coagulation can be reversed and pregnancy rates after reversal of bipolar tubal coagulation are approximately 66%.
Monopolar coagulation of the fallopian tubes is less common than bipolar coagulation tubal ligation.
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.
When a single site of the tube has been coagulated and divided, tubal reversal can be performed without difficulty.
Pregnancy rates after reversal of monopolar coagulation procedures are approximately 40-50%.
Reversing burned tubes
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. There is often considerable variation amongst doctors in their techniques of tubal coagulation but most doctors will use a 2 to 4 point burn applied to each tube and this can often be easily reversed.
Having burned tubes is not always as bad as it sounds and burned tubes can be reversed. In our experience most tubal coagulation procedures can be reversed and approximately 66% of our patients will report pregnancy after reversal of burned tubes.