Thursday, February 24, 2011

Consent for bilateral tubal ligation

1. Introduction

2. Explain indication

- 3 scar

-age more than 35 and completed family

3. Ask husband to join discussion if he is there

4. Ask patient what she knows regarding BTL

5. First of all, explain that this is permanent and irreversible procedure

6. If she understood and still want to proceed, continue to explain to her

7. If she did not agree,stop the discussion

8. Usually this procedure done together during LSCS, if done in daycare usually laparoscopic

9. Under GA/ CSE / epidural – anaest will review

10. Failure rate of BTL is 1 in 200 people (0.05%)

11. There is many type of BTL

- pomeroy method

-filshie clip/ hulka clip

- ring


12. Advantage of doing this BTL

-no compliance issues anymore for contraception

-not disrupt in sexual intercourse

- no hormonal manipulation

13. Correct any myth

- patient always think that BTL = menopause : explain that we don’t remove ovary, so hormone still release as usual,and they will have period normally

- they also think that this will decrease libido : explained that it is not related

14. Explain complication

-failure of BTL : ectopic pregnancy ( if missed period, come to check for UPT)

(due to recanalization and fistula formation)



-injury to bladder and ureter

source: ward round wad merah and dr nasir

hanisah A115275


siva said...

nice and good information... but i thnk laparoscopic procedure need to be done under GA. becoz need to distend the peritoneum. info from ward round too. BTL, thr is also possible of reversal but success rate is low and increase risk of ectopic tubal pregnancy. correct me if i have misunderstanding regarding this... gud luck yo!

Jack said...

There is also possible of change but success rate is low and improve chance of ectopic tubal maternity. appropriate me if i have misconception regarding this.
tubal reversal

Tubal Reversal said...

If you have previously undergone tubal ligation surgery and now planning to have a baby then only choose Tubal Reversal procedure because its success rate of getting pregnant is higher than other IVF treatments.

Tubal Reversal said...

Tubal ligation is not an permanent birth control procedure. There are many factors that help you to get pregnant after this surgery and tubal reversal is one of the famous and successful procedures.

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