Wanting to reverse your tubal ligation?

You are not alone in wanting to reverse your tubal ligation. Let's take a quick look at the facts presented by the CDC from their 1995 CREST study.

In this study, we learn that tubal ligation was done 1 1/2 to 2 times more often than a vasectomy as time went on from 1973 to 1982 and continued at that rate to the time frame of this study in 1995. I found this a surprising fact considering that in 1965, tubal ligation and vasectomy were equally as common.

Taking both forms of sterilization into account, the CDC considers 41% of women in the age group of 15-44 as being surgically sterile. Of these, 26% chose to have a tubal ligation because either the woman or the man in the relationship wanted no more children.

The number of women in this age group that had their tubes tied calculates out to 3,978,000 women. This figure remains pretty constant year in and year out.

Now, we get to the part of you finding out if you are alone in wanting a tubal ligation reversal or one among very few who want this. According to the CDC, almost 25% of women with tied tubes want a tubal ligation reversal. Turning to the calculator again, that comes out to 994,500 women. Almost a million women in any one year are wanting to reverse their tubal ligation. That's just in the U.S. alone. Many more women feel this way around the world.

So you can see you are far from being alone in your desire. Good thing you can get your tubes untied through another surgery called, as mentioned above, tubal ligation reversal. Once you know this, you move on to the next step toward having another pregnancy by researching your options.

There are things you do need to learn in order to help you make the best decision for you which will result in your end goal of a child. With the Internet at your fingertips you have many resources for your research.

The best place to begin and end your search, however, is the Chapel Hill Tubal Reversal Center's website at http://www.tubal-reversal.net/ Here you will find a message board where you can meet other women wanting the same thing as you as well as tons of information about tubal ligation reversal. Check it out today.

Dr. Berger Talks About Post Tubal Ligation Syndrome

Dr. Berger gives helpful advice to women with symptoms of Post Tubal Ligation Syndrome that may help with them with insurance coverage for testing and treatment.

Post Tubal Ligation Syndrome (PTLS)

PTLS Diagnosis and Tests

An email message received today about Post Tubal Ligation Syndrome (PTLS) from a patient who is scheduled for tubal reversal next month prompted this blog topic. I thought it would provide helpful information to others with similar concerns.

“My problem is horrible PTLS. I had my tubes tied in 05 at the time of my 3rd C-section. I understand that PTLS is not widely accepted or recognized in the medical community as a true syndrome or diagnosis, but could I expect to see something supporting that diagnosis in any blood work or hormone tests? Would it be normal to see abnormal hormone levels to some degree in support of this diagnosis or is it possible that all my levels would be ok but that the disruption in the flow of blood between ovaries and uterus could cause all of my symptoms and simply not show changes in hormone levels? Also, are there specific hormone tests I can have my ob/gyn check?

I only came across all this info on the net while desperately searching for answers to my growing list of symptoms that I never thought were related. This is very nerve wracking and exhausting. Three years is a long time and I look forward to this journey coming to an end and new one beginning, but I have so many questions and I was hoping you could steer me in the right direction so I can have any other diagnostics tests that may be helpful to my cause.”

Dr. Berger’s Response

One of the reasons that PTLS is not recognized as a true syndrome by most physicians is that there is no specific diagnostic test that is correlated with symptoms. If you search through the medical literature, you will find many studies with conflicting results. For example, you can do a search using Google Scholar for “hormones post tubal ligation syndrome” to review results from some recent medical studies.

Diagnostic Codes

There is no diagnostic code for Post Tubal Ligation Syndrome in the International Classification of Diseases (ICD). Without a specific diagnostic code, insurance companies do not provide reimbursement for testing or treatment. The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) does have other diagnostic codes that can be used, depending upon the symptoms being experienced:

• ICD-9-CM #625.0 Dyspareunia - Painful sexual intercourse.


• ICD-9-CM #625.3 Dysmenorrhea - Painful menstruation.


• ICD-9-CM #625.4 Premenstrual tension syndromes - Distressing physical, psychologic, or behavioral changes that occur during the luteal phase of the menstrual cycle. Symptoms of PMS are diverse (such as pain, water-retention, anxiety, cravings, and depression) and they diminish markedly 2 or 3 days after the initiation of menses.


• ICD-9-CM #626.2 Menorrhagia - Excessive menstruation.


• ICD-9-CM #626.6 Metrorrhagia - Irregular uterine bleeding.


• ICD-9-CM #627.0 Premenopausal menorrhagia


• ICD-9-CM #626.8 Disorders of menstruation, other
  

Insurance Coverage

Insurance companies do not recognize PTLS as a medical entity. Depending upon the symptoms you have, your doctor could use one or more of these diagnostic codes. The specific tests that may be appropriate will depend on your symptoms. For example, if you have pelvic pain, then ultrasound examination would be appropriate as part of an evaluation for pain. Abnormal menstrual bleeding would appropriately involve hormonal assays (FSH, LH, estradiol, progesterone). Based on the results of any preoperative testing, a diagnostic code could be listed on your operative report as a preoperative and postoperative diagnosis. This might influence the insurance company regarding possible reimbursement for tubal reversal surgery. Read your insurance policy carefully. If it specifically states that tubal reversal is not a covered benefit, no matter what information is sent to the insurance company, there will be no reimbursement. If the policy does not specify that tubal reversal is excluded, then there may be a possibility of getting reimbursement from your insurance carrier.

More Information about Post Tubal Ligation Syndrome

Post Tubal Ligation Syndrome is written about on many pages of the Chapel Hill Tubal Reversal Center website. There are also many discussions about PTLS on the Tubal Reversal Message Board. Another excellent source of information is Post Tubal Ligation Syndrome News.

13 Responses to “Post Tubal Ligation Syndrome (PTLS)”

1. Julia Smith RN Says: May 3rd, 2008 at 6:08 pm We hear from many women who describe a variety of problems and symptoms, with an onset that seemed to coincide with having their tubes tied. Dr. Berger began studying PTLS when it became clear that a certain percentage of our patients were mentioning similar symptoms. Many of the women contacted him after their surgeries to say the TR had helped them dramatically -even if pregnancy was their primary goal.


2. Charles Monteith MD Says: May 3rd, 2008 at 9:38 pm As a Ob/Gyn generalist, I was never impressed that I saw many patients who suffered from PTLS. Since joining the staff of Chapel Hill Tubal Reversal Center, however, it has become apparent to me that certain women do have worsening menstral periods and other symptoms after tubal ligation. Many of these patient state they have marked improvement after reversal surgery.


3. Rhonda Brown RN Says: May 5th, 2008 at 5:36 am We hear from women on a daily basis reporting many of these symptoms and seeking information on how they can get relief from PTLS. It saddens me when I hear from most of them that they have been told that nothing was wrong with them. It is apparent that something is going on and I am glad when I hear patients reporting relief from many of the symptoms after they have tubal reversal surgery. I am glad to see this information because I thnk that it will help answer many questions that alot of women have as well as let them know that there may just be hope out there for them after all.


4. Sally Muncy RN Says: May 5th, 2008 at 5:57 am I think that many of our patients just feel grateful to know that someone truly believes the symptoms that they are having are real. For the first time they feel that their feelings are validated and that they are not going out of their mind as some have stated. Thanks to Dr. Berger and his study we will learn more about PTLS and help even more women who wish to have their tubes untied.


5. Ericka Pamplin Says: May 5th, 2008 at 6:31 am With Dr. Berger’s study and ongoing reports from woman reporting relief, it would be awesome to see a code specifically for PTLS developed. Maybe this would prompt insurance companies to provide coverage for the tubal reversal.


6. Matt Murphy ST Says: May 5th, 2008 at 6:43 am I’m so glad that tubal ligation reversal surgery is not only allowing people to have kids again but also is helping to relieve the pains and discomforts of Post Tubal Ligation Syndrome.


7. Pamela Mills CRNA Says: May 5th, 2008 at 6:53 am This is such an important topic. We hear about PTLS symptoms so often from our ladies. Our tubal reversal message board is full of patients telling others how much better they feel after tubal reversal surgery. It appears it is nothing short of a miracle for some!


8. DrHertz Says: May 5th, 2008 at 7:11 am It is truly impressive to hear from women how their often their post tubal ligation symptoms are dismissed by other doctors, despite the history of the start of their problems with tubal ligation. It is gratifying to know we have something to offer these women and that many have reported feeling better after the tubal reversal procedure.


9. jgokun Says: May 5th, 2008 at 8:32 am I have talked to women for several years now that complain about PTLS. Often their local doctors tell them “It’s all in your head” and want to put them on antidepressants. This is really unfortunate, since most of these women are sure all of their symptoms started after their tubal ligation. Luckily, Dr. Berger has been able to help many women relieve their PTLS symptoms by performing the tubal reversal surgery for them. Patients often report total relief of symptoms within a couple months after their reversal with Dr. Berger.


10. Myrna White Says: May 5th, 2008 at 8:37 am We do hear from more and more women about having PTLS symptoms before having a tubal reversal. It is a great relief to hear from those who have had tubal reversal surgery and the symptoms of PTLS have disappeared.


11. Stephanie Duncan RN Says: May 5th, 2008 at 1:14 pm The education about post tubal ligation syndrome is fantastic! I hope that in the near future insurance companies and physicians will acknowledge this syndrome as they do other medical conditions.


12. Sarah Meachem RN Says: May 7th, 2008 at 10:58 am I always feel such empathy for our patients who have suffered from PTLS symptoms for a long time and have never been able to find any answers about or relief from PTLS. I think it is wonderful that tubal reversal surgery has the ability to relieve PTLS symptoms and help women to feel normal and healthy again.


13. Kathy Scrone ST Says: May 8th, 2008 at 8:00 am It takes the expertise of Dr. Berger to address and study the post tubal ligation symptoms that are such a viable complaint he hears from his patients. His research is ongoing from this study of similar adverse symptoms that one day will be accepted in the medical community.

PTLS Post Tubal Ligation Syndrome

Posted on the Tubal Reversal Message Board by a potential patient of Dr. Berger at Chapel Hill Tubal Reversal Center:

I believe I am a victim ot PTLS in forum New Message Board Members at Tubal Reversal Message Board
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Posted by Gialisa40 (Member # 8182) on May 29, 2005 09:58 AM :
I have had terrible PTLS symptoms that have only gotten worse. I was wondering does it matter how long you have had your tubal, can you still get it reversed? Will reversal help at any age? What if you are close to menopause? My doctor told me what he was doing couldn't be reversed, it was cut and burned. Is that true?
I appreciate any help or information anyone has to offer.
Thanks, Gialisa40
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Posted by Digger (Member # 7585) on May 29, 2005 11:00 AM :
The time length that you had your TL doesn't matter.My Dr told me mine couldn't be reversed either but Dr B DID reverse it.At times it the tube is too short or severely damaged it may not be reversed.Dr B will request your records from the TL to determine that and if you don't have access to those recors(which I didn't)he can do laproscopy to look before he does the TR.I wish you the best of luck!
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Posted by rkandlm (Member # 6776) on May 29, 2005 11:01 AM :
Gilalisa, My symptoms got worse and worse! It does not matter, from what I have heard, how long since your TL. Dr. B. can fix almost everything! Mine were cut and burned, and I still came out with 5.5 & 6 cm. I had my TR on 11-5-04, and I am now 22W 3D pregnan. After the TR, and before my BFP, all my symptoms went away. All I know for sure is how I went back to normal, and felt a ton better! Bonus.....I now get to be a mom again!YEA!
Hope this helps some, Lisa
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Posted by Rachel RN (Member # 1386) on May 29, 2005 12:36 PM :
Dear Gialisa, I'm sorry you have been having so much trouble with PTLS. Although most patients come to Dr. Berger for TR because they want more children, many women report either significant or total relief from PTLS symptoms following TR surgery. Many have reported reduction in cramping, bleeding, and number of days their periods last, as well as fewer mood swings and other problems. To my knowledge, there is not much data on this (maybe because so many doctors are still denying the existence of PTLS) but Dr. Berger is collecting these reports. Dr. Berger is able to repair the tubes in at least 95% of cases. Your age and length of time since TL are not factors in a successful repair (pregnancy rates, of course, ARE related to age). I suggest that you obtain a copy of the operative report from your TL procedure (from the surgeon who performed it, or the hospital where you had it done) and send it to Dr. Berger. He'll review it and a nurse will call you within a day or so to discuss everything. I hope to be taking care of you in the Recovery Room soon! Rachel Heller, RN
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Posted by tfaith (Member # 8133) on May 30, 2005 05:51 PM :
Gialisa,
You are not alone. I am a 44 year old woman with PTLS symptoms and broke down and cried when I found this site a week ago. No one believed me before. I had been told the only way I could find relief was to have a hysterectomy. My fear of only trading symptoms kept me from doing it. My reports have already been turned in and now I am waiting to have my FSH levels tested. As long as I am not on the verge of menopause I will be having a TR in the attempt to diminish my PTLS symptoms. I still have regualar cycles so feel confident Dr. B. can help me too. I already feel a heavy weight has been lifted, because now I have hope. You are younger than me and I am pressing on, and so can you. BTW - I had also been told that my tubes were burned but my report did not reflect that, so maybe your tubes weren't either.
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Posted by CL (Member # 6765) on May 31, 2005 11:12 PM :
Gialisa40, I can only tell you that my PTLS has gotten worse and in 9 days, I will be having my TR. I am looking foward to my first AF after that to see what happens. I am looking forward to having more energy and getting rid of the mood swings that have developed in the last month. The mood swings is what pushed my husband into getting my TR immediately. Of course, part of this happened because the good Lord helped us to sell our house to make all of this possible. All I can say, is that the day I found this site and discovered that I wasn't crazy and had a OB/GYN doc say that they call it PMS, not PTLS and walked out on me when I asked her morally and ethically didn't she feel obligated to tell her patients what could happen from a TL.
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Posted by taalah (Member # 8162) on May 31, 2005 11:20 PM :
I thought i was the only one having these symptoms and my gyno recommended me taking everything out and i am only 33 gosh i thought i was tripping out again but i suspected it was hormone related to my tl its like i morphed into a different woman will most of this go away when you have your tr and put your body back the way god intended it
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Posted by CL (Member # 6765) on June 01, 2005 01:03 AM :
taalah, I certainly hope so as I do not want to take birth control pills, prescription medication and have more test run to figure out how to deal with these symptoms. I guess in 9 days when I have the procedure and my body is put back together, I will find out. It certainly will be nice to have energy again instead of sitting around the house because that is all you can do. CL
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Posted by colette catalino (Member # 8184) on June 01, 2005 06:31 AM :
This is the first I've heard of PTLS. Since my TL 2 years ago and the return of my periods year ago I have experienced the worsest mood swings, abdominal pain, nausea and cramping not to mention feeling like I am pregnant every month from the abdominal bloating, breast tenderness, nausea and back cramps. After the third cycle I began to think I have excess scarring from the procedure or an artifact was left behind during the surgery. I want this craziness to end. How common is PTLS and does it continually get worse?? Confused and nutty....
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Posted by Gialisa40 (Member # 8182) on June 01, 2005 07:24 AM :
Yes Taalah,
I agree we should be the way God intended us to be. I kept waiting for my husband to have a vasectomy and he wouldn't, 6 kids later, I said I have to do something. Now with these symptoms I am sorry I did. For women we have a monthly cycle and our whole body undergoes changes constantly, we need our estrogen production. Men don't need to produce sperm, except when you want to conceive, which I think we have enough. My brother had a vasectomy and he had no negative symptoms. I just thought I would show the comparison of how much more we are affected by sterilization then men are.
Gialisa40
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Posted by Gialisa40 (Member # 8182) on June 01, 2005 07:29 AM :
Please CL let us know how you feel after.
Thanks so much for sharing! It is so good to know I am not alone.
Gialisa40
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Posted by mommakat (Member # 8204) on June 02, 2005 02:12 PM :
Hello everyone
I didn't know about ptls until I looked into this sight 3 years ago (wanting to get a reversal so my DH and I could have a baby together). I realized then that was exactly what I was experiancing. Not only did I have terrible mood swings (sometimes rageful)but I never knew when to expect my periods (typically 19-30+ days), which by the way were always very painful the first day. After my tr my cycles became very regular, I don't have the mood swings or even the pain anymore!!!
I had my tl Oct. 26th, 1994 after my youngest daughter was born and my tr on October 20th 2004. I have 3 children from my 1st marriage -ages 10, 12, & 14 and am remarried 1 1/2 years now with hopes of another bundle of joy soon.
-Kathleen
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Posted by tfaith (Member # 8133) on June 02, 2005 04:02 PM :
I wish I had found this site years ago, but am grateful for finding now.

Has anyone who was 40+ gone through the TR and found relief from PTLS? Ironically I found this site while researching pre-menopausal symptoms as my PMS keeps getting worse and I am approaching the age. But two things that have remained constant is that my AF's are still very regular and I still feel ovulation.
Thanks,
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Posted by taalah (Member # 8162) on June 02, 2005 11:11 PM :
congrads cl hope your tr goes well and wish you all the luck. i agree with some now let the men carry the procedures from here on because woman have enough to deal with already with everyday hormone problems.
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Posted by little j (Member # 7744) on June 03, 2005 07:04 PM :
Hellow girls,I'm 27 and I have 3 boys ages6,8,and 9 and I've been wanting to have a TR,How has this exprerience been for those who got it done?
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Posted by CL (Member # 6765) on June 05, 2005 12:14 PM :
Gialisa40, I will be glad to let you know how I am feeling.
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Posted by dephany (Member # 6570) on June 05, 2005 01:26 PM :
is ther anyone on line right now who i can talk to about there surgery send back a reply
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Posted by hopeann (Member # 7733) on June 06, 2005 01:10 PM :
Hey Ladies, I had my TR in January. Each month my cycle has been better. This month it was almost the same as before my TL. My period would be about 2 days with mild cramping, after the TL it would last for about 7 days with nausea and heavy cramping. I used to have a bad headache about a week before I was to start, but I believe my body is working this out because my headache is moving around during the month. I would believe it will deminish as well. I wish doctors would give people the information that ptls is possible. I am greatful to have the opportunity to fix my body and let it work as it is supposed to. Dr. Berger and his staff are the most professional and caring office I have met in any field of health care. Thank you Dr. Berger and Staff for all you do. Hope

More Information on PTLS