Sterilisation is a method of contraception which prevents pregnancy, without the need for hormones. There are different ways to be sterilised. Some ladies opt to have their sterilisation procedure after the birth of a baby, at the time of caesarian section. Others wait and have their sterilisation as an elective procedure some time later. Each method has implications for having reversal surgery.

In this article, we will discuss the different types of female sterilisation procedures available, how the length of the segment of tube removed impacts the likelihood of successful future reversal, and what pathology reports mean.

Different methods of Sterilisation 

Fallopian tube is not always removed when you are sterilised. It depends on which type of sterilisation procedure is used – cut & tie at caesarean,  laparoscopic clips/ diathermy & cut or Essure. 

A sterilisation procedure at caesarean usually involves the removal & tying (‘cut and tie’) of around 2-3 cm of fallopian tube off each side. As this procedure is designed to allow for a future reversal, there is usually plenty of tube left behind. You may get a pathology report from the hospital (if not, you can request one) which will tell you exactly how much tube was removed (providing less than 5cm was removed, reversal will be possible).

A laparoscopic sterilisation is where small clips are placed onto the fallopian tubes through small incisions in the abdomen. The clips or rings are added via a laparoscope through these “keyholes”. This procedure is usually conducted under a general anaesthetic and no tube is removed, leaving the tubes their original length. Occasionally a tube may be diathermied (burnt in the middle) and cut. Like with clip sterilisation, in this procedure no tube is removed, allowing a future reversal. 

There was, between 2009 and 2017, a method of sterilisation in the UK whereby an Essure device (a small metal coil) was inserted into each fallopian tube using a small camera passed through the neck of the womb, called a hysteroscope. This metal device encouraged the growth of tissue to block the fallopian tubes. This is no longer an option for sterilisation in the UK due to the post operative complications women were suffering. This procedure can however be reversed with Essure device removal and fallopian tube re-implantation.

Fallopian Tube Removal Pathology Reports

As mentioned above, if you have your tubes cut and tied, there will be a pathology report once the pathology doctors have inspected the portions of tube removed. The pathology report normally just confirms the length of tube, occasionally it may comment on any scarring or disease. You can request your pathology report from the hospital where it was performed.

How Much Tube Can Be Removed To Enable A Rejoin 

The pregnancy success rate following a reversal of female sterilisation is dependent upon many factors and not just how much tube is removed. Factors include the woman’s pregnancy history, age at time of reversal, type of sterilisation originally performed (clips typically have a slightly higher success rate as tubal length is not affected), any pre-existing fertility issues (such as problems with ovulation or a sperm count) and finally the skill and experience of the surgeon carrying out the reversal. 

Fortunately, it is rare that too much tube is removed to allow for a successful reversal. The fallopian tube is on average 10-14cm long, so providing less than 5cm of tube was removed from each tube, a reversal is possible. 

If you would like more information or would like to discuss having a reversal procedure, please get in touch by fill in our brief contact form to arrange a virtual or telephone consultation.