Salpingectomy

Salpingectomy is an operation to remove one or both fallopian tubes. Fallopian tubes are two muscular tubes that connect the uterus to the ovaries on either side. At the time of ovulation, these tubes receive the mature egg from the ovary and transport it to the uterus.

The removal of the fallopian tube will keep the eggs from travelling to the uterus and ultimately prevent future pregnancy as sperm can no longer reach the egg. Salpingectomy thus offers permanent birth control for women. This procedure is also done for the management of some health conditions associated with the fallopian tube.

Apart from birth control, salpingectomy is performed for multiple conditions.[3] Some of these conditions along with their symptoms are as follows:

• Fallopian tube cancer:

  • Watery or blood-stained vaginal discharge
  • Pain in the lower abdomen
  • Unusual bleeding that is not associated with menstruation
  • Lump in the lower abdomen
  • Feeling that the bladder or bowel is not emptied completely
  • Swelling of the lower abdomen that is not related to weight gain
  • A sensation of pressure against the bowel or bladder
• Endometriosis: Salpingectomy is suggested in severe cases of endometriosis, along with the removal of ovaries and uterus. Here are some signs of endometriosis:
  • Painful periods Read more: Period pain causes
  • Excessive bleeding
  • Pain during or after sex
  • Fatigue
  • Infertility
  • Pain while urinating
  • Constipation or diarrhoea
  • Bloating
  • Nausea
• Ectopic pregnancy: Salpingectomy is one of the ways to treat ectopic pregnancy, the other one being chemotherapy and salpingostomy (where the egg is removed with an incision and the tubes are not cut). The following are the symptoms of ectopic pregnancy
  • Missed period
  • Vaginal bleeding or brown, watery discharge
  • Discomfort while urinating or defecating (passing motion)
  • Tummy pain
  • Pain in the tip of your shoulder

If you have an ectopic pregnancy, your doctor will decide if you need to undergo surgery.

Any woman who wants to avoid future pregnancies or has endometriosis, fallopian tube cancer, and ectopic pregnancy can undergo salpingectomy if their doctor suggests they are fit for it. However, this surgery is not recommended in women with the following conditions:

• Very young age
• Incapable of making a medical decision on their own 
• Obesity that affects health 
• Those who are unsure whether they want to have a baby in the future

The following should be taken care of before the procedure:

• Your healthcare practitioner may order an imaging test of the fallopian tubes.
• You will have to fast after midnight in the evening before the surgery. 
• Avoid wearing jewellery or nail polish on the day of the surgery.
• If you smoke, your healthcare practitioner may ask you to quit smoking a while before the surgery.
• Inform your doctor if you take any medicines including non-prescribed or alternative medicines.
• Your doctor may ask you to stop taking some medicines, such as aspirin or anti-inflammatory medicines before the surgery.
• If you drink alcohol daily, you will be asked to reduce or cut down drinking before the surgery. It will help you heal faster.
• Carry sanitary pads as you may bleed after the surgery.
• Wear loose-fitted clothes on the day of the surgery.
• You may take medicines with a sip of water for up to two hours before the surgery.
• Arrange someone who can ride you to and from the hospital after the surgery.

Following steps are performed in this surgery:

• Your healthcare practitioner will start an intravenous (IV) line into a vein in your hand or arm.
• They will then give general anaesthesia through the IV. This procedure will relax your muscles and help you to have a pain-free surgery.
• You will be positioned for surgery, and the area of the incision (cut) will be cleaned with an antiseptic solution.
• The doctor will place a speculum inside your vagina.
• After this, he/she will insert a device into your uterus to position your uterus as needed in the surgery.
• The doctor will then make a small cut near your navel.
• Through the cut, he/she will pass a thin viewing tube called a laparoscope into your abdomen and pass gas through it to inflate your abdomen. This will help the doctor to get a clear view of the area.
• Next, the doctor will make a cut at your pubic hairline, and insert a special device through it for grasping your fallopian tubes.
• He/she will remove the tubes, and cover the cut with a small bandage.

This procedure takes 60-90 minutes.

After the surgery, you may need to stay for a few days in the hospital. The hospital staff will give you pain killer medicines after the surgery. They will take preventive steps to lower the risk of infection. These steps include keeping the area of incision covered and maintaining good hygiene by wearing gloves and masks.

Once you return home after the surgery, the following should be taken care of:

• Avoid drinking alcohol or driving for at least a day after the surgery.
• Avoid lifting anything heavy for one to two weeks after the surgery.
• You can resume your work in three days after the surgery.
• You can take a shower after the surgery. Avoid swimming or bathing in the tub for two weeks after the surgery.
• You may experience sore throat or swelling in the abdomen after the surgery.
• You may have mild discomfort due to gas in the abdomen.
• You can resume sexual activity in one week after the surgery.
• It is normal to have vaginal bleeding up to one month after the surgery.
• Many women may not have menstruation for four to six weeks after the surgery.
• You may have heavier bleeding and discomfort for the first two to three cycles after your menstrual cycle returns to normal.
• You may also have mild nausea. Avoid eating heavy meals on the day after the surgery.

When to See the Doctor?

Contact your doctor if you have the following symptoms after the surgery:

• Pain and burning during urination
• Heavy bleeding
• Swelling, pain or redness in your legs
• Fever
• Chills
• Unbearable pain that cannot be controlled by medicines
• Redness, swelling or leakage at the incision site

The risks of this surgery are as follows:

• Excessive bleeding
• Infection
• Organ damage
• Nausea and vomiting
• Anaesthesia allergy
• Blood clots

You will need to follow up with your healthcare practitioner within two to eight weeks after the surgery. 

Disclaimer: The above information is provided purely from an educational point of view and is in no way a substitute for medical advice by a qualified doctor.