Fallopian tubes
Benign / nonneoplastic
Posttubal ligation

Topic Completed: 1 July 2013

Revised: 23 August 2019

Copyright: (c) 2002-2019, PathologyOutlines.com, Inc.

PubMed Search: "Post tubal ligation"

Nicole Riddle, M.D.
Jamie Shutter, M.D.
Page views in 2018: 702
Page views in 2019 to date: 749
Cite this page: Riddle N, Shutter J. Posttubal ligation. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/fallopiantubesposttuballigation.html. Accessed November 19th, 2019.
Definition / general
  • Partial resection or closing of a segment of tube for the purpose of sterilization
  • Methods (Wikipedia: Tubal Ligation [Accessed 20 December 2018]):
    • Adiana tubal ligation: two small silicone pieces are placed in tube and heated, causing scar formation and blocking canal
    • Coagulation - bipolar: use of bipolar electrical current to cauterize tube
    • Coagulation - monopolar: use of monopolar electrical current to cauterize tube, allows radiating current to further damage tube as current spreads from coagulation site
    • Essure tubal ligation: two small metal and fiber coils are placed in tube causing scar tissue, blocking off canal
    • Fimbriectomy: eliminates ovary's ability to capture and transfer eggs to uterus
    • Irving procedure: place two sutures around fallopian tube and remove tubal segment between; then ends of fallopian tubes are connected to uterus and connective tissue
    • Pomeroy tubal ligation: loop of tube is tied with suture; then loop is cut and ends are cauterized
    • Tubal (Hulka) clip: permanent clip applied to tube
    • Tubal ring: doubling over of tubes and application of a silastic band
Clinical features
  • No / weak evidence for a "tubal ligation syndrome" (Fertil Steril 1998;69:179, BMC Womens Health 2005;5:5)
  • ~99% effective in first year; effectiveness reduced slightly in following years due to reformation or reconnection; when pregnancy occurs, 15 - 20% are ectopic and ~85% occur > 1 year after procedure
  • Recanalization or tuboperitoneal fistulas may allow openings large enough for passage of sperm but too small for ovum, resulting in fertilization and implantation in distal tubal segment
Gross description
  • Gross findings depend on procedure; typically ends of tube are blunted without an opening to the canal; clips or sutures may be present
Microscopic (histologic) description
  • Dilation of proximal tube, attenuation of plica with pseudopolyp formation and chronic inflammation
  • Plical thickening in distal tube, scar tissue
  • Occasionally endometriosis
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