Tubal occlusion involves an operation to close off the woman's fallopian tubes so that sperm cannot reach her eggs at ovulation. Unused eggs are reabsorbed into her body. It does not affect a woman's sexuality, her menstrual cycle or menopause. The tubes are cut and tied, or burnt with electrolysis or closed off with clips or rings through a laparoscopy or abdominal incision, using a general anaesthetic. You may need to stay overnight in hospital. About 2 to 9 per 1000 operations fail (soon after the operation or years later). If a pregnancy does occur, it is more likely to be ectopic.
Image 65-21 shows the woman's reproductive anatomy with the fallopian tubes.
Essure is a new method of occlusion which uses two small soft, flexible, titanium wires. They are inserted into the fallopian tubes via the vagina with a local anaesthetic, taking about 30 minutes. It then takes three months for tissue to grow over them to totally block off the tubes (confirmed by a pelvic X-ray). Other contraception needs to be continued until the tubes are completely blocked. Essure has less than 1% failure rate.
NOTE: A woman does not need her partner's permission to have a tubal occlusion.
Side effects. With a laparoscopy, abdominal and shoulder tip pain are common for a couple of days. You may react to the general anaesthetic with nausea and feeling lethargic for a few days. Occasionally bleeding or an infection can occur after the operation. With Essure, there may be some light bleeding and mild cramping for a day or so, but you should be able to return to normal activities the next day.
Breastfeeding. You can have a tubal occlusion while breastfeeding, but you may wish to wait until your child is 12 months old or so, before making a decision not to have any more children.
Advantages of a tubal occlusion are: