Tubal Ligation or Tubal Removal: What’s the Difference?
Key takeaways:
Tubal surgery is a good contraceptive option if you have no plans for a future pregnancy.
Tubal ligation involves blocking or cutting the fallopian tubes, while tubal removal actually removes the tubes.
Both procedures reduce your risk of ovarian cancer and can be done when having other pelvic surgery.
You may have heard of tubal ligation, or getting your tubes tied, as a method of contraception. But what does that actually mean? And is tubal ligation the same as tubal removal? Though they are not the same, they have similar benefits: They are both safe procedures meant to prevent unplanned pregnancies. And they may actually reduce your risk of cancer of the ovary.
Here’s how tubal surgery works and how to decide which option may be right for you.
What is a tubal ligation?
Your fallopian tubes connect your uterus to your ovaries. There is one on either side of the uterus. A tubal ligation permanently blocks the tubes so an egg cannot pass from the ovary to the uterus to form a baby.
There are different ways to block the tubes. Your surgeon may burn them, cut them, or tie them off with rubber bands or clips. You can have a tubal ligation right after you have a baby (postpartum tubal ligation), or you can do it anytime afterwards.
A postpartum tubal ligation is usually done through a small cut just below your belly button. A tubal ligation further out from pregnancy usually requires laparoscopy. This is a surgery using two or three small cuts on your belly and a camera to find your tubes and tie them off. Surgical risks like bleeding or infection are uncommon.
Because it is a permanent procedure, you will not be able to become pregnant again. So it’s a good idea to take your time with this decision and be certain that you do not want to carry any more children.
What are the benefits of a tubal ligation?
A tubal ligation is one of the most effective ways to prevent pregnancy: It is about 99% effective. It can be done at the time of a cesarean section or right after you deliver your baby, so there’s no need for a separate procedure, and it has to be done only once. These factors make it more convenient than some other forms of contraception.
There may also be other benefits to getting your tubes tied. A study done in 2010 in Canada found that tubal ligation decreased the risk of ovarian cancer. Many studies since have confirmed this ovarian cancer-risk reduction.
This is important because ovarian cancer is a very aggressive cancer. It causes more deaths than any other cancer of the female reproductive organs. It is often diagnosed late, making it more difficult to treat. Currently, there are no good tests to see if you are at high risk for ovarian cancer.
Is it better to get your tubes tied or removed?
A tubal ligation blocks a section of the fallopian tubes. But a tubal removal, or salpingectomy, takes the entire tube. Both procedures are permanent forms of contraception, and both also decrease your ovarian cancer risk.
There is evidence that some ovarian cancers form in the ends of the fallopian tubes near the ovaries. These parts of the tubes are not involved in a tubal ligation. They would, however, be removed in a salpingectomy.
The American College of Obstetricians and Gynecologists (ACOG) now recommends that anyone having any type of pelvic surgery be offered a salpingectomy for ovarian cancer prevention. For this reason, salpingectomy rates in the U.S. have increased from about 5% in 2010 to almost 60% in 2015.
Does having your tubes removed affect your hormones?
No. In most cases, it is beneficial to leave your ovaries intact during a tubal surgery. This is because your ovaries make hormones that protect you from other health conditions, including:
Heart disease (heart attack, stroke)
Bone disease (osteoporosis)
Mental decline (dementia)
Death at a younger age
If you have a high-risk gene for ovarian cancer, then you may need to have your ovaries removed. But for those at low risk, your ovaries are usually kept in place.
Tubal surgery also has little to no effect on your menstrual cycle. In fact, it may have beneficial effects, including less bleeding and less pain with your cycle.
Can my tubes grow back after tubal surgery?
No. Your tubes do not grow back. But tubal surgery may come with a small risk of an ectopic pregnancy. An ectopic (or tubal) pregnancy is a pregnancy that forms outside of the uterus. The chance of this happening after tubal surgery is less than one half of one percent.
What are the long-term side effects of tubal surgery?
Both tubal ligation and tubal removal are safe and very effective procedures. They do not affect your hormone levels. And they do not cause any problems with your cycle. They have not been linked to any long term side effects.
The bottom line
Getting your tubes tied or removed is a contraception option for anyone who has no plans for future pregnancy. These options also have the added benefit of decreasing your risk for ovarian cancer. This is why ACOG recommends offering a salpingectomy to anyone having pelvic surgery of any kind. Your healthcare provider can help you decide if tubal surgery may be an option for you.
Why trust our experts?
References
American College of Obstetricians and Gynecologists. (2017). Hormone therapy in primary ovarian insufficiency.
American College of Obstetrics and Gynecology. (2018). Ectopic pregnancy.
American College of Obstetricians and Gynecologists. (2019). Benefits and risks of sterilization.
American College of Obstetricians and Gynecologists. (2019). Opportunistic salpingectomy as a strategy for epithelial ovarian cancer prevention.
Mandelbaum R. S., et al. (2020). The rapid adoption of opportunistic salpingectomy at the time of hysterectomy for benign gynecologic disease in the United States. American Journal of Obstetrics and Gynecology.
McAlpine, J. N., et al. (2014). Ovarian Cancer Research Program of British Columbia. Opportunistic salpingectomy: Uptake, risks, and complications of a regional initiative for ovarian cancer prevention. American Journal of Obstetrics and Gynecology.
Society of Gynecologic Oncology. (2013) SGO clinical practice statement: Salpingectomy for ovarian cancer prevention.
