Remove My Fallopian Tubes?

May 28, 2015 9:08 AM

I went to a tubal ligation consult yesterday and left ready to schedule a bilateral salpingectomy (removal of fallopian tubes). Given that I didn't know it was an option, am I crazy for considering it?

First, I want to be totally clear that sterilization is what I want. Yes, my husband could and should have a vasectomy if he wanted, but this is something I've wanted for myself for longer than I've known him. Besides, what if he dies suddenly before me?

I recently got decent insurance coverage for the first time in years, so I decided it was finally time. A co-worker recommended the doctor who delivered her last child and performed her tubal.

I did my research. I was pleasantly surprised by his patient reviews and also that I could find out so much about him. Not only does he specialize in Da Vinci robotic surgery, he's pretty much in top of his field, traveling around the world to teach Da Vinci. I've just finished watching him preform several surgeries on YouTube.

So I'm totally comfortable with my decision for permanent birth control, and after meeting him, I'm completely comfortable with my doctor/surgeon. But, removing my fallopian tubes? I mean, when he told me about it, I was excited. No hormonal side effects and might lower my cancer risk? No chance of it reversing itself and next-to-no chance of ectopic pregnancy? That sounds almost too good to be true. Is it?

I can find next to nothing about bilateral salpingectomy as a sterilization method online. There's a lot about cancer risk reduction and as part of a hysterectomy, but none of that is really relevant to me.

I would really like resources to help me make this decision. I would also appreciate personal stories of experience with either Da Vinci surgery in general or fallopian tube removal. Negative long-term effects? Recovery time? What should I know/consider/ask?

The doctor actually described several types of possible procedures including Essure (which I'm totally not considering), three or four types of tubal ligation, and the removal of my tubes. How do I even decide which method is right for me?

posted by MuChao to Health & Fitness (9 answers total)

Personal anecdote: I had a single side laprascopic salpingectomy (because of an ectopic pregnancy) and the recovery time was really minimal. I was home the same day and pretty much fully functioning the next, with no pain, which may have been unusual. The worst side effects were from the general anasthesia. and I think that is variable depending on the skill of the anesthesiologist and other factors, I had fewer issues with a planned surgery. I know people vary a lot with how they handle general.
posted by vunder at 9:36 AM on May 28, 2015

Best answer: A couple I know has six children when they planned on two, due to the failures of (in order of time) condoms, two vasectomies, and a tubal ligation. After the tubal failed she had a salpingectomy and has had no further pregnancies. If she's had long term side effects I don't know about them, but I can ask her if you like.

I feel honor bound to say here that she is obviously a statistical outlier -- both vasectomy and tubal ligation are extremely reliable forms of birth control and the odds that they'd be failed by both of them are staggering. But she was, and a salpingectomy worked.
posted by KathrynT at 9:37 AM on May 28, 2015 [2 favorites]

I had mine out with my uterus and cervix so I can't really speak to what the recovery time is like for just the tubes. I would go for it though, just be aware that they pump you full of gas and your first moments in the recovery room will be nurse-related people encouraging you to fart with all your might.

my only concern is that they'd be removed whole. idk if there are any specific tubal cancers that would go undetected by scans or whatnot but there's that whole morcellation cancer-spreading hysterectomy thing that scares the crap out of me. don't let them shred anything and suck it out through a tube, basically.
posted by poffin boffin at 9:40 AM on May 28, 2015 [1 favorite]

Best answer: i had mine removed (no cancer risk, but there was no chance i was ever going to want kids, and i wanted to make that permanent), along with an endometrial ablation to take care of my horrendous periods (which also contributes to lack of pregnancy). 7+ months later, and i have no regrets whatsoever. i had nothing else taken out, just the tubes. had the surgery on a wednesday, could have gone back to work on monday, but doctor told me 2 weeks, so i listened to her - it was my first surgery ever, and i wasn't sure if something else would happen in those two weeks or something, but i was totally fine.

no one encouraged me to fart, but i was told that due to the gas they use to blow you up a little for visibility's sake, my doctor told me my shoulders might hurt for a day or so, and she was correct.

if you need any more anecdata, feel free to msg me.
posted by koroshiya at 10:37 AM on May 28, 2015 [1 favorite]

Best answer: The cancer risk reduction is a bigger deal than you might think - there's recent evidence that many ovarian cancers can be prevented by tube removal, and about 1 in 70 women will develop ovarian cancer in their lifetime. Some doctors are starting to recommend salpingectomy over tubal ligation for that reason. I'd definitely take the tubes out, if I were in your position. The decreased (eliminated?) chance of failure is a nice bonus.
posted by randomnity at 10:45 AM on May 28, 2015

Whatever you end up doing, I wouldn't get too hung up on whether your surgeon uses a robotic vs standard laparoscopic approach. I've never seen a study that showed clinically relevant improvements in outcomes for a robot vs the standard approach for pretty much any procedure, not just salpingectomy.
posted by un petit cadeau at 12:51 PM on May 28, 2015 [1 favorite]

I'm arguably at the extreme worst-case scenario for this kind of operation - I've had one tube AND one ovary removed, but it was an emergency operation to alleviate a freak ovarian issue, and so they had to just jump straight to getting me under a knife rather than doing a calm and patient laproscopy.

But even here, the recovery wasn't all that bad, and most of it was probably related to the fact that I had a 4-inch abdominal incision rather than a laproscopy. They kept me in the hospital for a day and a half after the surgery, and I chilled out at home for a week after before going back to work; but even there, I was able to walk around a little (and was encouraged to do so, in fact) and the only discomfort I experienced that week was just if I coughed or laughed or did anything that tightened my abs. Within a week I was back at work, and while I was still taking it easy for another couple weeks (I didn't lift anything heavy), I was okay.

But again, that discomfort was entirely due to the huge-ass incision itself; I didn't feel anything wrong or weird or abnormal about my tube being gone. You'll probably have a much easier recovery with any kind of a laproscopy.
posted by EmpressCallipygos at 1:16 PM on May 28, 2015

You might want to check out the forums over at hystersisters.com. IIRC, they have a board for hysterectomy alternatives.
posted by tuesdayschild at 1:50 PM on May 28, 2015

Response by poster: I just want to thank everyone who shared and calmed my anxiety.

I had my bilateral salpingectomy this afternoon and am now home resting and Netflix binging. I was really nervous at first because I'd never been under general anesthesia before. It was nothing! Almost literally. A nurse put something in my iv, rolled me out of my room and I only remember passing through two doors and waking up in recovery. I don't even remember the breathing tube, and while hoarse, wouldn't know I had one if they hadn't told me.

I only required the single incision and doc said I did great. Overall, a pretty good experience. If anyone (anyone reading this ever) would like more details, feel free to (m)email me. I don't know if it's allowed/appropriate here, but if you're in the Austin area and need a gynecological surgeon recommendation, let me know.

Thank you everyone for your kind anecdata and advice and helping me make the right decision for me.
posted by MuChao at 5:47 PM on June 29, 2015 [1 favorite]