The reproductive system is composed of the external genitalia and internal structures including the uterus, fallopian tubes and ovaries. Fallopian tubes or oviducts are a conduit for fertilized eggs to reach the womb for implantation. Some women opt to have their tubes ligated as a method of family planning. Occasionally, the tubes may be accidentally tied during pelvic operations for other reasons. Tubal reversal surgery is considered for women of reproductive age who wish to have more children.
Not every woman with ligated tubes is fit for this kind of operation. A thorough evaluation is usually needed before any major decisions are made. The doctor will ask the patient a number questions in a bid to determine their reproductive history and to establish why the process is necessary. A history of previous pelvic operations is particularly important. Such operations are necessitated by conditions such as ectopic pregnancies, pelvic inflammatory disease and even operative deliveries.
A focused physical examination is necessary in ruling out other causes of infertility such as an intact hymen or an incompetent cervix. Examination also helps to pick up any existing infections which need to be treated first before operation. Some of the priority investigations performed following physical examination include a pelvic ultrasound and a special procedure called a hysterosalpingogram (HSG). These two combined help determine the status of the oviducts in terms of length and functionality.
Pinhole surgery is an alternative to open method for reversal. The only disadvantage of this method is that it takes times to be mastered. The good thing about it is that it is of short duration and does not invade the tissues too much. The patient is put to sleep through anaesthesia to ensure they are not traumatized by the procedure.
One of the common factors that may render the operation useless is age. Women below the age of forty stand a better chance of conceiving than those above. A history past pelvic operations causes and increase in adhesion formation which may end up clogging the tube again. Moreover, couples with other underlying issues with their fertility have very little chance of success in pregnancy if these are not sorted out.
Comparable to other surgeries, reversal surgery can complicated with excessive blood loss, neighbouring soft tissue injury and infection which may develop later on. In the long run, fibrous tissue may form causing obstruction again. Ectopic pregnancies are also much more among women who have had their tubes untied.
Some of the complications encountered are preventable. For instance, simply maintaining sterile measures when treating the patient goes a long way in keeping infections at bay. In addition, prophylactic antibiotics can be given to provide cover. Patients with low blood volumes should be stabilized first before being taken to theatre to avoid the dangers of excessive bleeding.
Tubal restoration operation is a procedure that has restored the hope of many who wish to have more children after surgical contraception . However, certain factors including old age, and complications of previous surgeries reduce the chances of success. Technical errors also lower success rates. Reversal can be done directly using the open method or through the use of keyhole surgeries.
Not every woman with ligated tubes is fit for this kind of operation. A thorough evaluation is usually needed before any major decisions are made. The doctor will ask the patient a number questions in a bid to determine their reproductive history and to establish why the process is necessary. A history of previous pelvic operations is particularly important. Such operations are necessitated by conditions such as ectopic pregnancies, pelvic inflammatory disease and even operative deliveries.
A focused physical examination is necessary in ruling out other causes of infertility such as an intact hymen or an incompetent cervix. Examination also helps to pick up any existing infections which need to be treated first before operation. Some of the priority investigations performed following physical examination include a pelvic ultrasound and a special procedure called a hysterosalpingogram (HSG). These two combined help determine the status of the oviducts in terms of length and functionality.
Pinhole surgery is an alternative to open method for reversal. The only disadvantage of this method is that it takes times to be mastered. The good thing about it is that it is of short duration and does not invade the tissues too much. The patient is put to sleep through anaesthesia to ensure they are not traumatized by the procedure.
One of the common factors that may render the operation useless is age. Women below the age of forty stand a better chance of conceiving than those above. A history past pelvic operations causes and increase in adhesion formation which may end up clogging the tube again. Moreover, couples with other underlying issues with their fertility have very little chance of success in pregnancy if these are not sorted out.
Comparable to other surgeries, reversal surgery can complicated with excessive blood loss, neighbouring soft tissue injury and infection which may develop later on. In the long run, fibrous tissue may form causing obstruction again. Ectopic pregnancies are also much more among women who have had their tubes untied.
Some of the complications encountered are preventable. For instance, simply maintaining sterile measures when treating the patient goes a long way in keeping infections at bay. In addition, prophylactic antibiotics can be given to provide cover. Patients with low blood volumes should be stabilized first before being taken to theatre to avoid the dangers of excessive bleeding.
Tubal restoration operation is a procedure that has restored the hope of many who wish to have more children after surgical contraception . However, certain factors including old age, and complications of previous surgeries reduce the chances of success. Technical errors also lower success rates. Reversal can be done directly using the open method or through the use of keyhole surgeries.
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