A tubal removal, medically called a salpingectomy, is a surgical procedure in which one or both fallopian tubes are taken out. It’s performed for a range of reasons: as a form of permanent birth control, to treat an ectopic pregnancy, or to lower the risk of ovarian cancer. The procedure is minimally invasive in most cases and has a low complication rate of about 2.8%.
Why Tubal Removal Is Performed
The fallopian tubes connect the ovaries to the uterus. Eggs travel through them after ovulation, and fertilization typically happens inside them. Removing one tube (unilateral salpingectomy) or both tubes (bilateral salpingectomy) may be recommended for several distinct reasons.
The most common indications include:
- Permanent contraception. Removing both tubes is increasingly preferred over traditional tubal ligation (tying or clipping the tubes) because it eliminates the small risk of the tubes reconnecting over time. The 10-year failure rate for tubal sterilization techniques overall is just 0.02%, and complete removal of both tubes is considered even more reliable, though no pregnancies from it have been formally documented in research.
- Ectopic pregnancy. When a fertilized egg implants inside a fallopian tube instead of the uterus, the tube sometimes needs to be removed to stop dangerous internal bleeding.
- Ovarian cancer risk reduction. Research now shows that many ovarian cancers actually originate in the fallopian tubes. Removing both tubes has been associated with roughly an 80% reduction in ovarian cancer risk. If adopted widely, this approach could reduce ovarian cancer deaths in the U.S. by an estimated 15%.
- Blocked or damaged tubes. Conditions like severe infection or fluid-filled tubes (hydrosalpinx) can cause chronic pain or interfere with fertility treatments. Removal may be the best option when repair isn’t viable.
- Endometriosis. Endometrial tissue growing on or inside the fallopian tubes can cause significant pain and may require removal.
- Cancer treatment. Cancers of the uterus, ovaries, or fallopian tubes may require salpingectomy as part of a broader surgical plan.
How the Surgery Works
Most tubal removals are done laparoscopically, meaning through a few small incisions in the abdomen rather than one large cut. A tiny camera and surgical instruments are inserted through these incisions, and the surgeon detaches the fallopian tube from the uterus and ovary before removing it. You’re under general anesthesia for the procedure, so you’re fully asleep throughout.
In some cases, such as during a cesarean section or when other pelvic surgery is already happening, the tubes may be removed through a larger abdominal incision that’s already open. The surgical approach depends on the reason for the procedure and whether other operations are being performed at the same time.
What Happens to Your Hormones
One of the most common concerns about tubal removal is whether it will trigger early menopause or change hormone levels. The short answer: it does not. Your ovaries, not your fallopian tubes, produce estrogen and progesterone. Removing the tubes leaves the ovaries completely intact and functioning normally.
A study comparing women who had undergone salpingectomy to women who hadn’t found no significant difference in ovarian reserve, the measure of how many eggs your ovaries still hold. Researchers looked at multiple hormone markers and egg counts and concluded that salpingectomy does not have an adverse effect on ovarian function. You’ll continue to have periods, experience normal hormonal cycles, and go through menopause at whatever age your body was already programmed to.
Recovery After Tubal Removal
Recovery from a laparoscopic salpingectomy is relatively quick compared to open abdominal surgery. Most people go home the same day or the next morning. You can expect some bloating, mild abdominal soreness, and fatigue for the first few days. The small incision sites may be tender, and shoulder pain from the gas used to inflate the abdomen during surgery is common but temporary.
For non-strenuous activities like light housework, short walks, and desk work, most people feel ready within one to two weeks. Strenuous activities, including heavy lifting, vigorous exercise, and physically demanding jobs, typically require four to five weeks before they feel comfortable again. Some surgeons recommend avoiding lifting anything over about 20 pounds for the first few weeks. Driving is usually restricted for two to three weeks, partly because of anesthesia effects and partly because twisting to check blind spots can strain the incision area.
If the salpingectomy was done through a larger abdominal incision, recovery takes longer, closer to six weeks for full activity.
Risks and Complications
A large population-based study found that bilateral salpingectomy as a standalone procedure carries a complication rate of 2.8%. That figure includes everything from minor issues requiring an extra doctor visit to more serious events like returning to the operating room. The rate was similar whether the surgery was done for contraception (2.7%) or for cancer prevention (4.5%), with no statistically significant difference between the two groups.
The most common risks are the same as any laparoscopic surgery: infection at the incision sites, bleeding, reactions to anesthesia, and very rarely, accidental injury to nearby organs like the bladder or bowel. Serious complications are uncommon.
Fertility After Tubal Removal
If only one tube is removed, pregnancy can still happen naturally through the remaining tube. Ovulation alternates between ovaries each cycle, and the remaining tube can sometimes pick up an egg from either side.
If both tubes are removed, natural conception is no longer possible. Eggs have no pathway to reach the uterus, and sperm have no pathway to reach the egg. However, IVF (in vitro fertilization) remains an option because it bypasses the fallopian tubes entirely. Eggs are retrieved directly from the ovaries and fertilized in a lab before being placed into the uterus. Since tubal removal doesn’t affect ovarian reserve, egg quality and quantity remain the same as they would have been without the surgery.
Tubal Removal vs. Tubal Ligation
Traditional tubal ligation works by cutting, tying, clipping, or burning sections of the fallopian tubes to block them. The tubes stay in your body. A tubal removal takes the tubes out entirely. Both are considered permanent sterilization, but removal has two significant advantages.
First, it’s more effective at preventing pregnancy. Tubal ligation has a small but real failure rate because tubes can occasionally grow back together or a clip can shift. Complete removal eliminates that possibility. Second, removing the tubes provides the substantial ovarian cancer risk reduction that ligation does not fully offer. For these reasons, many medical organizations now recommend salpingectomy over traditional ligation when permanent contraception is the goal.
The trade-off is that tubal removal is slightly more involved surgically and is essentially irreversible. Tubal ligation can sometimes be reversed, though success rates vary. Once the tubes are removed, reversal is not an option.