As a leading ob-gyn in the New York City area, Dr. Pilshchik offers bilateral tubal ligation procedures for women who want a more permanent form of birth control.
Bilateral tubal ligation (BTL) is a birth control procedure that's performed to prevent egg (ovum) fertilization by blocking off the fallopian tubes, the tubes that transport the ovum from the ovaries to the uterus during ovulation. Bilateral means it's performed on both fallopian tubes, using techniques like cutting, burning (cautery) or placing special clips on the tubes to close them off.
Once you're anesthetized, several small incisions are made in your belly, and the area will be inflated with gas so it can be seen more clearly during the procedure. A special device called a laparoscope will be inserted through an incision to locate the fallopian tubes, and instruments designed to be used in small incisions will be inserted through other incisions to perform the ligation procedure. Once the procedure is complete, the incisions will be closed. You can go home the same day.
Immediately after your procedure, you may notice some discomfort or aching in your shoulder from the gas used to expand the belly area, but this will soon dissipate. You'll also be given pain medication for a few days to a week to help manage any discomfort following the procedure itself. Most patients take about two weeks to heal, and you'll need to avoid exercise and sex until your follow-up visit. You'll be able to drive once you stop taking any narcotic pain medication.
Although it may be reversible, BTL is considered a permanent type of birth control, and women should understand that reversing a tubal ligation can result in damage to the fallopian tubes which would prohibit pregnancy. For that reason, BTL can be ideal for women who are sure they no longer want to become pregnant.
IUDs are small, T-shaped devices that are implanted in the uterus where they prevent fertilization by killing or damaging sperm. Copper IUDs cause the uterus and fallopian tubes to produce a substance that's toxic to sperm; other IUDs contain hormones that increase mucus production in the mouth of the uterus (the cervix) to make it more difficult for sperm to enter, while also thinning out the uterine lining to prevent egg implantation. IUDs that use hormones may also decrease menstrual bleeding and cramping.
IUD placement takes just a few minutes in the doctor's office. Before placing an IUD, Dr. Wirth will make sure you don't have a pelvic infection and you're not pregnant. In a few cases, a local anesthetic can be injected into the cervix to prevent discomfort, but it isn't necessary. Women who have given birth through vaginal delivery will find insertion easier.
IUDs are attached to a long plastic string that extends into the vagina. Once the IUD is inserted, the doctor will encourage you to feel for the string so you can make sure it's still in place. You'll also be asked to return in a few weeks for a followup visit to make sure it's still properly positioned.
Although it rarely happens, an IUD can become dislodged, especially during the first 12 months following implantation. That's why it's important to check for the plastic string before and after having sex. If you IUD falls out, call the office immediately.
IUDs are associated with a very small risk of pelvic inflammation, and there's also a very small risk of uterine perforation, which can occur during insertion.