Often there are situations when, for one reason or another, a woman does not want to have children. This is not about the classic methods of contraception, with the abolition of which pregnancy will occur, but about sterilization, when it will no longer be possible to give birth in the future. Bandaging is one such method of female sterilization. fallopian tubes, the pros and cons of which we will reveal in our article.
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The fallopian tubes are the place where the egg moves after maturation and release from the follicle. In addition, it is there that fertilization and further movement of the embryo into the uterine cavity with its subsequent fixation to the wall takes place. Violation of the patency of the tubes by ligation is considered one of the most reliable methods of contraception, which almost 100% protects against unwanted pregnancy.
It is not necessary to have any pathologies or diseases in order to perform such an operation. In most cases, this is done by perfectly healthy women who have decided that they will not give birth to children. These are not only childfree, who are categorically against children, but also women who already have one or more. Also, tubal ligation in a woman can be performed due to the presence of certain health problems in which it is risky to give birth to children. It could be:
- serious heart defects, vascular diseases;
- diabetes;
- genetic hereditary diseases;
- malignant tumors;
- pathology of the lungs, kidneys and others.
Often, tubal ligation is done during a caesarean section, if there are any problems or pathologies during the first pregnancy, which make it clear that further births can be life-threatening for the mother.
The main types of dressings
Pipes can:
- cut;
- bandage;
- seal by soldering.
The most common techniques used for tubal ligation are:
- laparotomy;
- minilaparotomy;
- laparoscopy.
Depending on the chosen method, the cost may vary.
The main plus is a 100% guarantee that pregnancy will not occur. But, this is also the main disadvantage, because the process is almost irreversible. This means that the woman who made the dressing, then, if she changes her mind and decides to give birth to another child, will not be able to do it. In rare cases, tubal patency can be repaired with surgery, but this is very difficult. IVF is the only way to get pregnant. But this procedure does not give a 100% guarantee, because the first time it may not work.
Consequences of the operation
If everything is in order, there will be no negative consequences after tubal ligation, except that the woman will lose her childbearing function. This is a mechanical surgical intervention, so there is no negative effect on the body. There is no hormonal failure, as, for example, often happens when taking oral contraceptives. Also, this procedure does not affect the libido of a woman. Therefore, in general, everything will be the same as before, except that pregnancy will not occur even with unprotected intercourse. Of course, this does not mean that a woman can sleep with different partners, often change them and not be protected. No, the number of partners is her own business, but if she is not sure about him, that he is healthy, it is better not to risk it and use a condom so as not to pick up anything.
How much does a tubal ligation cost
The cost of a tubal ligation operation is different, depending on the city in which it is performed, in a public clinic or a private one, which method is used. Tubal ligation prices range from 4,000 to 50,000 rubles. In some state medical institutions, perform this procedure can be free of charge with the help of a mandatory policy health insurance. Also, do not forget that this is a surgical intervention, before which it is necessary to pass a series of tests, which are also paid in most cases. Prices can be found in advance on the websites of selected clinics. But, it is better to focus not only on the cost, but also on the reputation of the institution itself, doctors, patient reviews.
Today, tubal ligation is considered the most effective method of birth control, since after such a procedure, pregnancy, as a rule, becomes impossible. Its use is recommended for women who voluntarily refuse to plan children in the future, as well as in cases where pregnancy is unbearably difficult for the body and can threaten the life and health of the expectant mother.
The tubal ligation procedure, in fact, is an operation and is expressed in blocking, tying, clamping with special devices or cutting the fallopian tubes in order to form an artificial obstruction. Female sterilization or voluntary surgical contraception is a highly effective method of contraception. Today, for this purpose, special tubal implants have also been developed, which have the form of metal springs, which are installed directly in the fallopian tubes, are performed non-surgically, that is, without dissection. As time passes, scar tissue forms around each implant, which is a kind of tube blocker.
As you know, after maturation, the egg leaves the ovary and immediately moves to the fallopian tubes, where it is fertilized, and from there it penetrates into the uterine cavity. Since the passage is blocked, accordingly, fertilization does not occur and pregnancy does not occur. The high contraceptive effect of this surgical method is based on this mechanism.
It is important to know that tubal ligation is your voluntary refusal to conceive children, after such a procedure, pregnancy will never occur. Of course, if necessary, the functioning of the tubes can be restored, but the percentage that a woman can become pregnant again is very low, since it is difficult to reunite the cut ends of the tubes. The procedure is performed exclusively by a highly professional and experienced gynecologist.
Blocking of the fallopian tubes can be carried out in several ways, among which are the application of staples or tying, cauterization (electrocoagulation), cutting and suturing, etc. All of them are performed using various methods. 
The abdominal method is represented by laparoscopy (mini-laparotomy) and laparotomy. Laparotomy (open tubal ligation) is performed under anesthesia. During the operation, the doctor cuts the surface in the abdomen and performs ligation of the fallopian tubes. This technique is recommended mainly if a woman has diseases of the pelvic organs of an inflammatory nature (they contribute to the formation of scar tissue, which is a contraindication for performing this operation in a different way), endometriosis, during an operation on the abdominal cavity for another reason (for example, cesarean section).
The laparoscopy operation (mini-laparotomy) is performed under general anesthesia and is expressed through a small upper incision (up to 5 cm) on the abdomen of a viewing device (camera) and a surgical instrument. Then another (lower, in the pubic area) incision is made, which is intended for clamping. First, gas is blown into the abdomen for greater convenience, and then the dressing is directly performed with metal clips or clips, and then the ends of the tubes are sealed by applying an eclectic current (cauterization or electrocoagulation). After the operation, the woman is in the hospital for a week. After the operation, a large scar is formed. 
Very often, women resort to this method of surgical contraception immediately after childbirth, after 24-36 hours. This question is considered in advance by the woman and her partner (husband) and discussed with the doctor. The incision is made in the navel area, because after childbirth, the tubes are slightly higher in the abdominal cavity, which is caused by an increase in the uterus.
The vaginal method of ligation of the fallopian tubes is carried out by colpotomy. During the operation, the doctor makes an incision through the back wall of the vagina in order to penetrate into abdominal cavity. After the operation, there are practically no scars, but the risk of infection increases significantly. Therefore, one of the mandatory recommendations after the intervention is a complete renunciation of sexual activity for a month and a half.
Endoscopy of the uterus is one of the latest ways to block the fallopian tubes. The ends of the tubes during the operation are closed with plastic microtampons.
Since tubal ligation is a serious operation, like any intervention in the body, it can be accompanied by the development of adverse reactions, among the most common are allergies to anesthesia, bleeding, ectopic pregnancy against the background of incomplete blocking of the tubes, blood poisoning.
Restoration of the functions of the fallopian tubes is possible, but the probability of a positive outcome is very scanty. Therefore, tubal ligation is considered an irreversible method of contraception.
Tubal implant procedure.
The procedure is carried out with the introduction local anesthesia in an outpatient setting. It takes no more than half an hour. The specialist, using special tools, opens the woman's cervix, and then, with gentle movements, very slowly inserts the implant in the form of a thin tube (catheter) through the cervix and directly into the uterus itself, first into one and then the other fallopian tube. After insertion, a woman may experience something like cramps, which are observed during menstruation. After the procedure, the doctor necessarily checks with the help of X-ray examination the correctness of the installation of the implants. During the first three months of using implants, a woman should use additional contraceptives. After this period, she comes to see a doctor. There, a specialist will inject a dye into the uterine cavity and do a hysterosalpingography, which will show how tightly the tubes are blocked by scar tissue. If everything is in order, then additional contraceptives can no longer be used. 
If suspicious symptoms are observed after tubal ligation or the introduction of tubal implants, it is recommended that you definitely consult a doctor to exclude ectopic pregnancy, as one of the risks of sterilization. These symptoms include symptoms of pregnancy (nausea, lack of menstruation, sensitivity of the mammary glands), pain in the lower abdomen on any side, dizziness.
In cases where pain in the lower abdomen does not go away when implants are installed, a decision can be made to remove them. With this method of contraception, there is a risk of developing diseases of the pelvic organs. To prevent this, before the procedure for the introduction of implants, a woman must be examined for the presence of STDs and vaginal infections.
After operation.
After surgical intervention there may be slight bleeding from the vagina due to the movement of the uterus at the time of surgery. After laparoscopy, there may be back pain and bloating due to the gas used. You will get rid of this inconvenience after one or two days, as the body gets rid of gas.
After a day, you can take a shower, but touching and rubbing a place of size is not recommended for another week. During the week, it is recommended to protect yourself from physical activity, sexual contacts. Such operations do not require the use of additional contraceptives. Two weeks after the intervention, you need to visit a doctor.
Indications for tubal ligation.
- Women over thirty-five years of age, necessarily having at least one child.
- Absolute confidence in their unwillingness to have children in the future.
- The presence of a disease that can aggravate pregnancy.
- Having a severe hereditary disease that can be passed on to children .
- The absence of diseases that can make tubal ligation impossible.
The effectiveness of the method of tubal ligation or surgical sterilization is almost one hundred percent effective. With this technique, there is a small chance of pregnancy, but it is so small that you should not count on it. Therefore, if you decide on such a method of contraception, do not console yourself with hopes for possible pregnancy in future.
Pregnancy can occur in the case of fused fallopian tubes or the formation of a new passage (recanalization), if the operation is performed incorrectly, if there is pregnancy before the intervention. But the latter is unlikely, because before that the woman undergoes an examination and takes tests. It is simply impossible to miss such a fact!
Consequences and risks of tubal ligation.
As a rule, there are no serious complications during tubal ligation, usually these are minor bleeding, an allergy to anesthesia. However, there is always a risk of damage internal organs during the operation of laparoscopy (the moment of introduction of the laparoscope). In addition, the risks increase if the patient suffers diabetes, overweight smokes or has heart disease.
It should be noted that blocking the fallopian tubes will not affect the ovulatory function and the menstrual cycle in any way, that is, the egg will mature monthly, and menstruation will occur in the future. Regarding menopause, it will come in due time, as if you had not had an operation. In addition, it is important to know that this method of preventing an unplanned pregnancy will not protect you from sexually transmitted diseases. Therefore, if you are not sure about your partner, then additionally use other contraceptives (condom).
Before performing the operation, the specialist examines the woman in detail, and also carefully examines her family relationships especially in terms of stability. This is due to the fact that often, after a lapse of time, patients are asked to return their ability to conceive, that is, to restore the functions of the tubes. This mainly happens against the background of the loss of a child (death) or the creation of a new family.
Tubal ligation is necessarily legally formalized from the legal side. The woman signs a document where she officially agrees to the operation. Before you sign, remember that statistically, women who do so will later regret it.
Nowadays, there is a huge variety of methods and means of contraception, each woman can choose the most optimal option for herself. Tubal ligation or sterilization should only be performed when absolutely indicated. The choice of the method of the operation is chosen by the doctor, taking into account individual characteristics female body.
Consequences of tubal ligation: sepsis, vascular ruptures, bleeding, anaphylactic shock from anesthesia during surgery, inflammatory processes, a small percentage of unwanted pregnancies (6 out of 1000 women still "fly" after tubal ligation).
Features of tubal ligation in women
Tubal ligation in a woman is considered one of the reliable ways to prevent unwanted pregnancy. This is a kind of sterilization method, which is performed through surgical intervention. If done correctly, tubal ligation will forever eliminate the possibility of pregnancy. Tubal ligation is recommended in certain situations. So, this procedure is relevant when a woman cannot bear a child safely for her health. Also, this method of irreversible contraception is used if there are contraindications in the use of oral agents, spirals. Very often, tubal ligation is done by women when they voluntarily refuse to have children.
The purpose of this method of contraception is to achieve artificial obstruction of the fallopian tubes. As a result, the spermatozoa will not have any opportunity to meet the egg and then fertilize it.
"Female Sterilization" has its own legal implications. Thus, the obligatory legal agreement of the woman for this operation is necessary, the signing of a number of different documents. After a woman contacts a medical institution with her desire to have a tubal ligation, a certain time is allotted for reflection (to think carefully about her decision). When allotted time will pass and the woman agrees to the operation, she will need to sign an official document - an agreement. Such documents are legally binding.
Tubal ligation methods
There are several ways to ligate the fallopian tubes. Can do: bandaging and circumcision; tying or imposing special staples; cutting and cauterization.
There are such types of surgery:
- - laparoscopy, aparotomy (surgery of the abdominal cavity);
- – endoscopy of the uterus with subsequent application of special plastic micro-tampons;
- - colpotomy (the so-called vaginal method).
All these operations are performed under anesthesia. They are not very long in duration - about half an hour. A few days after the operation, the patient is already discharged home. Experts assure that the risk of complications after these operations is minimal. And only in quite rare cases, there may be some side effects. We will deal with this issue in more detail.
Side effects after tubal ligation in women
Whatever Doctors Say About Minimal Risks side effects and the consequences of tubal ligation, yet in practice, many face various problems. Those who have undergone such an operation say that immediately after it there may be severe weakness and even temporary pain. There is also the possibility of dizziness, cramps (which resemble period pains), and bloating. Often there is nausea. All this can be attributed to the side effects of the reaction of the female body to anesthesia and surgery.
After the tubal ligation is normal in the body of women, there are no special changes. At the same time, weight is not gained, if we compare this method of contraception with hormonal contraceptives. The libido (sexual desire) of a woman also remains normal. As for hormonal changes, they do not occur. And all due to the fact that female hormones, as before, are produced by the fair sex. Also, after the operation, it is not disturbed and menstrual cycle. It basically stays the same as it was before. If a woman decides to ligate the fallopian tubes, then she must clearly understand that she will no longer be able to have children. This method of protection is considered irreversible.
Consequences of tubal ligation in women
No matter how sad it may sound, sometimes tubal ligation operations are not very successful. Some stages of the operation may be incorrectly or poorly performed. Because of this, women can be very dire consequences . For example, sepsis may develop. The integrity of the blood vessels (rupture of the vessels) may also be compromised. Sometimes, after a tubal ligation, a woman suddenly starts bleeding. It is also not necessary to exclude the possibility that an anaphylactic shock can occur in a woman from anesthesia. The consequences of tubal ligation operations include the possibility of developing various inflammatory processes. If the tubal ligation was done incorrectly, then the woman will be able to become pregnant.
According to statistics, after this procedure, 6 out of 1000 women still "fly".
As you can see, all these listed consequences are very serious in themselves. And some women after a tubal ligation operation suffer a whole “bouquet” of such consequences. It is believed that tubal ligation is fundamentally different from other methods of contraception: after this procedure, the reproductive function of a woman is completely and forever eliminated. But in world practice there are women who gave birth to children even after tubal ligation. Of course, the percentage of such women is very small. It is almost impossible to get into his number. Therefore, this fact must always be remembered. It is not difficult to perform the operation, but it can be very difficult to deal with the consequences.
In order not to face disastrous consequences after a tubal ligation operation, it is recommended to carefully plan this procedure, find out the necessary information, compare reviews, take into account the reputation of the clinic, the experience of certain doctors. It is best to perform such an operation in stationary clinics. You should also unconditionally follow all the recommendations of doctors regarding the rehabilitation period.
Reviews of tubal ligation
Statistics is one thing. But what women say after tubal ligation surgery is much more interesting. Reviews very a large number of. Of course, in the world great amount women who were satisfied with their chosen tubal ligation procedure. They speak well of this operation, as they no longer need to worry about whether an unplanned pregnancy will occur. Their head no longer hurts about how to protect themselves. Some point out that their husbands are now very happy, as they no longer need to use additional protection in the form. After all, as you know, almost no one likes sex with a condom.
Someone speaks in favor of a tubal ligation operation, since after it, the libido remains in order. Not everyone can boast of this fact while taking oral contraceptives. As you know, hormones greatly reduce libido. After the operation, there are no problems with desire in women. Among the reviews you can also find those in which women praise the operation precisely because of the material aspect. In the future, they no longer need to spend extra money on contraceptives, which in our time are not very cheap.
Among the reviews about tubal ligation, you can find a lot of negativity. Many say that this is still a surgical intervention, which has a high risk of postoperative complications. Someone after the operation had heavy bleeding, someone had adhesions, someone had sepsis. Some even managed to get pregnant and give birth to an unplanned child. As you can see, there are a lot of reviews: both bad and good.
We are found:
- Can I lose my desire to have sex after a tubal ligation?
At the moment, surgical ligation of the fallopian tubes - abbreviated PMT is considered the most effective and efficient contraception. In what cases do they practice this species contraception and to whom it is contraindicated, how to carry it out? Consider all the pros and cons of tubal ligation.
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Why do tubal ligation
At its core, PMT is a surgical intervention in the female reproductive system and blocking by bandaging or clamping, cutting the fallopian tubes and creating an artificial obstruction.
Simply put, this is female sterilization, irreversible in nature, to prevent conception and pregnancy.
Pros and cons of bandaging
The main advantage of PMT for a woman is the opportunity to conduct an active sexual life and not be afraid of unwanted pregnancy. In addition, doctors and women themselves highlight the following points:
Regarding the disadvantages of this procedure:
- There are many complications after PMT - inflammation and bleeding, which are provoked by infection and sepsis. Such consequences are not uncommon in the ligation of the fallopian tubes during caesarean section.
- infertility by female type- irreversible, and if the technology is violated, the risk of developing ectopic pregnancy.
- The need to use anesthesia - not every woman tolerates the introduction of anesthesia well, which complicates the choice of contraception.
Indications for the procedure
PMT is carried out for all women over 35 years old who have their own children and do not want to become pregnant and give birth again in the future. It is also carried out in the diagnosis of pathologies that can aggravate the course of pregnancy, cause spontaneous miscarriage or the birth of a child with pathologies. The cause and basis is the diagnosis of a disease that can be transmitted to a child at the genetic level and in the absence of pathologies that make the operation itself impossible. Not in the last place is the threat to the life of a woman, which pregnancy can carry for her.
Contraindications
To the absolute contraindications for bandaging, doctors include a diagnosed inflammatory process occurring in the pelvic organs and obesity, as well as identified benign / malignant tumors, strong adhesions in the cavity of the pelvic organs.
Also, PMT can be delayed for a while due to severe, general diseases and inflammatory processes that make it impossible to use anesthesia and surgical intervention.
Rules for preparing for surgery
The rules for preparing for dressing provide for a number of examinations. This is blood donation for research - HIV and coagulation, as well as an examination by a gynecologist, fluorography and ECG, ultrasound. This will determine the general condition reproductive system and the condition of the woman in general, to choose the best option for surgical intervention and eliminate all negative consequences.
Tubal ligation is carried out in several ways:
- Laparoscopy- the safest of all methods of conducting PMT, which is carried out in an outpatient setting and using local anesthesia. Injuries during its implementation are minimal, there are no scars on the skin, the rehabilitation period is about a week.
- Laparotomy — in this case, the dressing is done after a caesarean section.
- Minilaparotomy — the method is applicable after childbirth, when surgery is performed in the first days after delivery. Carried out by laparoscopy. The procedure is also classified as low-traumatic.
- Colpotomy- it is carried out in a hospital, when access to the fallopian tubes is carried out through the rectum, then the uterine space. The advantage of surgery is affordability and lack of scarring, there is no need to use expensive equipment.
Minus - the recovery period takes about 1-1.5 months, the probability of infection is high.
- — dressing is performed using a hysteroscope inserted through the cervical canal. The method is not widely used due to the high percentage of complications, low efficiency.
Consequences of the procedure
In question possible complications— doctors identify early and late negative consequences after PMT:
- Early negative consequences include internal bleeding and intestinal damage, as well as the development of sepsis.
- To later negative consequences, doctors include a failure in the hormonal background and a violation of the cycle of menstrual flow, an ectopic type of pregnancy and mental failures.
In addition, in both cases, the development of necrosis and other negative consequences is possible, regardless of the method of surgical intervention.
Operation cost
The price of tubal ligation by laparoscopy or otherwise - ranges from 9 to 80 thousand rubles, if it is carried out simultaneously with a caesarean section - the cost will vary from 22 to 54 thousand rubles.
Tubal ligation is one of the most effective procedures for preventing unwanted pregnancies, as future conception becomes almost impossible. Usually, such a step is taken by girls who voluntarily gave up the prospect of having a child, as well as women for whom pregnancy itself can become a threat to life and health.
Female sterilization is a surgical intervention that is performed to create an artificial obstruction of the tubes. Today, this method of contraception can be called the most effective and at the same time the most radical. How does tubal ligation surgery prevent pregnancy?
The ovum, having matured, leaves the ovary and moves to the fallopian tubes, where fertilization should occur. Then it enters the uterine cavity. After the operation, the passage becomes blocked - fertilization becomes impossible and pregnancy does not occur. This is the contraceptive effect.
In addition to the desire of a woman to exclude the possibility of pregnancy, there are medical indications that may affect the need for surgery.
Indications
- Rupture of the uterus
- Leukemia - cancer of the blood
- Severe diabetes mellitus
- Chronic diseases of the heart and blood vessels
- Malignant neoplasms
- History of removal of vital organs
- Mental illnesses such as schizophrenia
- Congenital heart disease
Types of surgical sterilization
- subdivided into laparoscopy and laparotomy.
Laparotomy performed under general anesthesia. The operation involves dissection of tissues in the abdomen and subsequent ligation of the tubes. Most often, the doctor recommends an open dressing if the patient has a history of pelvic inflammatory disease. The fact is that such pathologies cause scarring of tissues - this fact makes other types of surgical intervention impossible. A laparotomy can also be part of another operation in the abdomen, such as a caesarean section.
Laparoscopy requires general anesthesia is performed through a small incision in the abdomen - about 5 cm. A camera is inserted through the incision into the abdominal cavity and surgical instruments are manipulated. After that, a second incision is added (for clamping), already in the pubic area. Bandaging is carried out with clips or a metal clip. After exposure, the ends of the tubes are cauterized or sealed by electrocoagulation.
Often tubal ligation is used immediately after childbirth, literally 1-2 days later. Of course, such an operation is planned in advance and discussed with the attending physician. This is due to the fact that after childbirth, the tubes are higher than normal due to the increase in the uterus. Therefore, during the operation, an incision is made in the navel.
- vaginal method is a tubal ligation using a colpotomy. That is, the surgeon performs a tissue incision through the back wall of the vagina - this provides access to the abdominal cavity. Next, the necessary manipulations are performed to ligate the fallopian tubes. When tubal ligation by this method increases the risk of infection - accordingly, after colpotomy, it is necessary to give up sexual activity for 1-2 months.
IMPORTANT! There is only a minimal possibility of restoring the functions of the reproductive organ after surgery, which is why surgical sterilization is called an irreversible method of contraception.
Postoperative period
Due to the movements of the uterus during the operation, the rehabilitation period is often accompanied by bleeding from the vagina. In addition, after the intervention, bloating, discomfort and back pain may occur. But these unpleasant consequences quickly disappear. After a day, the patient can take a shower, but it is not recommended to touch the site of tissue incision for 7-10 days.
Of course, the rehabilitation period means giving up intense physical activity and sexual contact for 1-2 weeks. In the future, additional contraception will not be required. 14 days after the operation, you need to visit the doctor who performed the operation - it is necessary to examine and monitor the patient's condition.
Tubal ligation: pros and cons
- Almost 100% contraceptive effect. During sexual intercourse, protection is not required, since after a correctly performed operation, pregnancy is excluded.
- Changes in the hormonal background and the occurrence of side effects are excluded - for example, a sharp increase in body weight or diseases of the female genital organs.
- The absence of changes in sexual desire - the libido does not change, the cycle is not broken.
- There is no need for special preparation for the operation - the dressing can be performed immediately after childbirth or during a caesarean section.
- The intervention does not affect the overall health of the woman.
Despite a number of advantages and confidence in contraception, tubal ligation has its drawbacks. However, in most cases they depend on the quality of the surgical intervention and the skill of the doctor.
- Possible complications - infection, etc.
- The negative aspects of the rehabilitation period are weakness, nausea, vomiting.
- The negligence of the surgeon can lead to an ectopic pregnancy in the patient in the future.
Possible Complications
Any operation entails certain consequences - they may be irreversible, but it is also possible to restore all body functions. The irreversible consequences of surgical sterilization are, of course, the inability of a woman to become pregnant. This fact cannot be fully called a consequence of the operation, since it is at the same time its goal.
The most popular complication is the risk of infection, as well as the possibility of side effects. This is especially true of the vaginal method - often during the colpotomy, vessels are damaged, inflammatory processes open and bleeding occurs. These facts have a negative impact on the health status of women and the rehabilitation period. You may need additional therapy after tubal ligation surgery.
It is worth considering the individual reaction of the patient - an allergy may occur. Moreover, such a response of the body can follow not only anesthesia (any type of anesthesia), but also medicines, which are applied during the recovery period after surgery. These consequences occur quite rarely and depend on individual characteristics - on the characteristics of the body and the qualifications of doctors.
When thinking about surgical sterilization, it is worthwhile to thoroughly analyze the situation and weigh all the pros and cons, because the result of the operation cannot be canceled, the woman will lose the opportunity to conceive and bear a child. Having decided on the ligation of the fallopian tubes, one should responsibly approach the choice of a doctor and the implementation of his recommendations before and after the intervention.