Hysteroscopic Occlusion Of The Fallopian Tubes For Sterilization

What you should know

• Hysteroscopic occlusion of the fallopian tubes is a procedure to block your fallopian tubes to prevent pregnancy. Your fallopian tubes are thin tubes located on each side of your uterus (womb) near the ovaries. Your ovaries are the organs that release eggs into the fallopian tubes. You may become pregnant if sperm enters your egg. Hysteroscopic occlusion of the fallopian tubes is a form of sterilization. Sterilization means permanent (lifelong) prevention of pregnancy. Before having this procedure, you must be sure that you never want to have babies in the future.
  
  
• Your caregiver will use a hysteroscope, which is a long tube with a camera and light on the end. The scope is used to insert special sterilization coils into your fallopian tubes. The coil is made of metals including nickel. There is a substance inside the coil that will irritate the tissue that lines your tubes. The irritation then causes tissue to grow around the coil and block the opening of your tubes. Once your tubes are completely blocked, sperm will not be able to reach your egg and cause pregnancy.

Care Agreement

You have the right to help plan your care. To help with this plan, you should learn about all forms of birth control. You can then discuss treatment options with your caregiver. You may then decide if the procedure is best for you. If you have a partner, it may be best to make the decision together. Make sure all of your questions are answered. You always have the right to refuse the advice of caregivers.

Risks

• You may have an allergic response to the medicine used during your procedure. You also may have an allergic response to the metal coil used for your procedure. After your procedure, you may have nausea (upset stomach), dizziness, or feel faint. You may have abnormal vaginal bleeding or spotting. You may also have cramping or pain in your abdomen (stomach) and lower back. Your uterus or fallopian tubes may get a tear from your procedure. You may get blood clots, and they may block your veins (blood vessels). The coil may move out of place, and may move into another area of your body like your uterus.
  
  
• It will take at least three months after your procedure for your tubes to be completely blocked. You may still get pregnant during that time. You will need to use a form of birth control until your caregiver says the blockage is complete. Even after three months, your tubes may not be blocked. When this happens, you may need to have another procedure or surgery to permanently prevent pregnancy. Ask your caregiver if you have questions or concerns about your procedure or care.

Getting Ready

Before your procedure:

• Ask someone to drive you home after your procedure. Do not drive yourself home.
  
  
• Tell your caregiver about medical problems you have, or have had. These include a pelvic infection, cancer of the cervix, or allergies to any medicines or nickel. Tell your caregiver if you have had tubal ligation surgery. Tell him if you have ever been told your uterus is an abnormal shape.
  
  
• You may need to take birth control pills before your procedure. Tell your caregiver if you are taking any medicine, herbs, or food supplements. Do not stop any of your medicines without asking your caregiver first.
  
  
• Tell your caregiver the date of your last monthly period. Your procedure may need to be scheduled for the early part of your period.
  
  
• Tell your caregiver if you have recently given birth, or had an abortion or miscarriage. Tell him if you are using an intrauterine device (IUD) as a form of birth control. Your IUD may need to be removed before your procedure.
  
  
• Tell your caregiver if you know you are or think you might be pregnant. You may need to have a pregnancy test done before your procedure. Ask your caregiver for more information about any tests that you may need. Write down the date, time, and location of each test.

The day of your procedure:

• Write down the correct date, time, and location of your procedure.
  
  
• You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
  
  
• Pain medicine: Caregivers may give you medicine to take away or decrease any pain you may have during your procedure.
  
  
• Sedative: A sedative medicine may be given before your procedure to make you relaxed and sleepy.
  
  
• Anesthesia: Anesthesia medicine is not always used for this procedure. If you choose to have anesthesia, an anesthesiologist may talk to you before your procedure. Tell your caregiver if you or anyone in your family has had a problem with anesthesia in the past. Caregivers may insert an intravenous tube (IV) into your vein if you will have anesthesia. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine. You may get the following:
  
  
  • Local anesthesia: This medicine is given as a shot into your cervix. It is used to numb the area and dull your pain. With local anesthesia, you will be fully awake during the procedure. You may still feel pressure during your procedure, but you should not feel any pain.
    
    
  • General anesthesia: This is medicine that may be given in your IV or as a gas that you breathe. You may wear a face mask or have a tube placed in your mouth and throat. This tube is called an endotracheal tube or ET tube. Usually you are asleep before caregivers put the tube into your throat. The ET tube is usually removed before you wake up. You are completely asleep and free from pain during surgery.

Treatment

What will happen:

• You will be placed on a table with your knees bent and feet in special holders. A hysteroscope will be inserted into your uterus through your vagina and cervix. A camera at the end of the scope will show the inside of your uterus on a TV-like screen. A salt water solution will be inserted through the scope. This solution makes your uterus larger and allows your caregiver to better see your tubes.
  
  
• When the opening of your tube is seen, a thin wire will be put through the scope. The coil will be attached to the wire. The wire will be inserted into the opening of your tube. The coil will then be released into the tube. Once released, the coil will expand and attach to your tube wall. After the coil is in your tube, the wire and scope will be removed. The same procedure will then be done for your other tube.

After your procedure:

You will be taken to a room where you can rest. Do not get out of bed until your caregiver says it is OK. Your caregiver will check you for any bleeding or pain. Tell your caregiver if you feel any pain in your lower back, legs, hips, or thighs. When you are able to walk without help, drink fluids, and urinate, you may be able to go home.

Contact a caregiver if

• You cannot make it to your procedure.
  
  
• You did not have your monthly period and think you may be pregnant.
  
  
• You know you are pregnant.
  
  
• You get sick (cold or flu), or have a fever (high body temperature).