Lo que toda mujer debe saber sobre la cirugía esterilizante

Por: Dr. Juan Francisco Solís Bercián, Ginecólogo y Obstetra, Especialista en Fertilidad

Luego de que una mujer decide ya no tener hijos y opta por la cirugía esterilizante de las trompas de Falopio, es muy difícil que se revierta la esterilización, por lo que es una decisión que debe hacerse con mucha meditación ya que debe tomarse como algo definitivo.

Vale resaltar que un número incalculable de mujeres se arrepienten de haber tomado esta decisión. Es recomendable que se consideren los métodos de planificación familiar que existen actualmente, los cuales no son tan radicales y muy seguros, de largo plazo y que deja abierta la posibilidad al embarazo en el futuro.

En la mujer que desea tener hijos después de una cirugía esterilizante de las Trompas de Faliopio, puede intentarse una cirugía de recanalización de trompas. Sin embargo, los resultados no son muy buenos. Menos de 50% logran un embarazo después de esta cirugía de reversión y un porcentaje alto de las mujeres que lo logran resultan en un embarazo ectópico (fuera del útero, generalmente en las mismas trompas de Falopio).

La recomendación entonces es que aquella mujer que haya tenido una cirugía esterilizante y desea volver a lograr un embarazo sea por fertilización in vitro, ya que en este tratamiento la fertilización se hace en el laboratorio y se pasan los óvulos ya fertilizados y en división (embriones) directamente al útero, “saltándose” el paso por las trompas de Falopio. Con este método se puede esperar un porcentaje alto de éxito (hasta 80% en los primeros tres intentos).

En el caso de obstrución tubárica por causas no quirúrgicas, es decir, cuando una paciente presenta una o ambas trompas tapadas por algún proceso inflamatorio, como enfermedades de transmisión sexual (clamidia o gonococo) o por endometriosis, el resultado de la cirugía, ya sea abierta (laparotomía) o por laparoscopía, es muy malo, tanto así que no vale la pena ni siquiera intentarla.

Los resultados de la cirugía de trompas por obstrucción o por enfermedad adherencial son muy malos, ya que generalmente la inflamación post operatoria y la manipulación intraoperatoria es tal que hace que las trompas se vuelvan a tapar o adherir.


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