What Causes Pelvic Pain After a Tubal Ligation?

stomach pain
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Getting a tubal ligation, or having your tubes tied, is a common procedure among women of reproductive age. Many women opt for tubal ligation as a form of family planning, choosing to have their tubes tied once they have children. During the procedure, the fallopian tubes are cauterized or burned, and a clip is placed in each tube preventing eggs and sperm from traveling through the tubes.

You can get your tubes tied as a short outpatient procedure or following birth, after a C-section. Although the procedure can be reversed, it is considered a form of permanent birth control. Reversing a tubal ligation is difficult, requiring major surgery, and is not always successful. 

Pain After a Surgical Tubal Ligation

You may experience some pain or discomfort following a tubal ligation as it is a surgical procedure. You should be able to return to work and normal activities within a few days following the procedure. Your doctor might advise you to wait longer before resuming more physical activities, like exercise, as well as sexual intercourse. 

If your pain continues, speak to your doctor. It is possible to develop scar tissue and adhesions following pelvic surgery; however, complications following tubal ligation are considered rare. 

Other Forms of Tubal Ligation and Pain 

In addition to surgical tubal ligation, noninvasive tubal ligation was available with the Essure FDA-approved insert (discontinued in the United States in 2018). Essure is placed into the fallopian tubes using a hysteroscopy, a scope that looks in your uterus. Within three months a barrier of scar tissue forms around the inserts, preventing pregnancy. Other preventative measures must be taken during those three months to prevent pregnancy. 

Complications from Essure can lead to chronic pelvic pain. The FDA has received complaints of Essure causing chronic pain, uterine and fallopian tube perforation, migration of the implants into the pelvis, irregular bleeding and allergic reactions.

Following complaints, the FDA asked Bayer, the company which makes Essure, to continue studying the risks of Essure as well as issue a warning that the product can cause adverse reactions on the box. Sales were restricted in April, 2018 to doctors and health care facilities that used an approved checklist. Bayer discontinued sales and distribution of the device in the U.S. at the end of 2018.

Assessing Chronic Pelvic Pain

If your pelvic pain persists following a tubal ligation or Essure insertion, your doctor may order imaging tests, like an ultrasound, to rule out other causes of pelvic pain including fibroids, cysts, and adhesions. Other pelvic conditions which can cause chronic pain, like endometriosis and adenomyosis, are difficult to diagnose through imaging and require a laparoscopy.

If your doctor is not sure what is causing your pain, they may recommend an exploratory procedure to rule out surgical complications.

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