A bilateral salpingectomy is the surgical removal of both fallopian tubes. It is one of the most effective forms of permanent contraception available, and it also significantly lowers the risk of ovarian cancer. The procedure leaves the ovaries and uterus in place, which means it does not trigger menopause or affect your hormone levels.
How the Procedure Works
The fallopian tubes are the narrow channels that connect each ovary to the uterus. In a natural menstrual cycle, an egg travels through one of these tubes, where fertilization would normally occur. During a bilateral salpingectomy, a surgeon removes both tubes entirely, rather than cutting, clipping, or blocking them (which is what happens in a traditional tubal ligation).
Most bilateral salpingectomies are performed laparoscopically. The surgeon makes a few small incisions in the abdomen, inserts a camera and instruments, and removes both tubes. The laparoscopic approach typically takes about an hour or less. An open abdominal approach, which involves a larger incision, can take several hours and is generally reserved for cases where laparoscopy isn’t feasible, such as during a cesarean delivery or when significant scar tissue is present.
The procedure is sometimes done on its own, but it’s also commonly performed at the same time as another pelvic surgery, like a hysterectomy or cesarean section. When it’s added to a surgery already being performed, it’s called an “opportunistic salpingectomy,” a practice now widely supported by gynecologic organizations.
Why It’s Done
People choose bilateral salpingectomy for two main reasons: permanent birth control and cancer risk reduction. As a sterilization method, it is at least as effective as traditional tubal ligation, and a systematic review and meta-analysis found it may carry a lower pregnancy rate, though the difference did not quite reach statistical significance. The key advantage is that because the tubes are completely removed rather than simply blocked, there is essentially no path for an egg and sperm to meet.
The cancer prevention benefit is substantial. Research from a large Swedish study found that women who underwent bilateral salpingectomy had a 65% reduction in ovarian cancer risk, compared to a 28% reduction with standard tubal ligation alone. Scientists now believe that many ovarian cancers actually originate in the fallopian tubes, which is why full removal offers more protection. The American College of Obstetricians and Gynecologists supports opportunistic salpingectomy as a strategy for reducing ovarian cancer risk.
Bilateral salpingectomy may also be recommended to treat certain medical conditions, including ectopic pregnancy (when an embryo implants in a fallopian tube), tubes blocked by infection or endometriosis, or a buildup of fluid in the tubes called hydrosalpinx, which can interfere with IVF success.
Effects on Hormones and Menstruation
One of the most common concerns about this surgery is whether it will cause hormonal changes. It does not. The fallopian tubes do not produce hormones. Your ovaries, which remain in place, continue making estrogen, progesterone, and other hormones just as they did before. You will still ovulate each month, still have menstrual periods, and will not experience early menopause as a result of the surgery.
This is an important distinction from a bilateral oophorectomy, which removes the ovaries and does cause immediate surgical menopause. A salpingectomy with ovarian preservation keeps your entire hormonal system intact.
Recovery Timeline
Recovery depends largely on whether the surgery was laparoscopic or open. After a laparoscopic bilateral salpingectomy, most people go home the same day. You can expect some abdominal soreness, bloating, and fatigue for the first few days. Shoulder pain from the gas used to inflate the abdomen during surgery is also common and typically resolves within a day or two.
Most people return to desk work and light daily activities within about a week. Strenuous exercise, heavy lifting, and sexual activity are generally off-limits for about two to four weeks, depending on your surgeon’s guidance and how you feel. Full recovery from laparoscopic surgery usually takes one to two weeks. Open abdominal surgery involves a longer recovery, often four to six weeks, because of the larger incision and greater tissue disruption.
Risks and Complications
Bilateral salpingectomy is considered a safe procedure, particularly when done laparoscopically. The risks are similar to those of any pelvic surgery: infection, bleeding, blood clots, and accidental injury to nearby structures like the bladder, bowel, or blood vessels. Reactions to anesthesia are also possible but uncommon. Serious complications are rare, and the systematic review comparing salpingectomy to tubal ligation concluded that salpingectomy is equally safe.
Fertility After the Procedure
Bilateral salpingectomy is permanent and irreversible. Unlike tubal ligation, where reversal surgery is sometimes attempted, there is no way to reconnect tubes that have been fully removed. Natural conception is not possible afterward because eggs released by the ovaries have no way to reach the uterus or encounter sperm.
However, pregnancy through IVF remains an option. IVF bypasses the fallopian tubes entirely. Eggs are retrieved directly from the ovaries, fertilized with sperm in a laboratory, and the resulting embryo is transferred into the uterus. Because your ovaries still function normally after salpingectomy, they can respond to the fertility medications used in IVF cycles. For anyone considering this surgery who thinks they might want biological children in the future, IVF is the primary path to pregnancy afterward.
How It Compares to Tubal Ligation
Traditional tubal ligation blocks the fallopian tubes by cutting, tying, clipping, or cauterizing them, but leaves the tubes in the body. Bilateral salpingectomy removes them entirely. The two procedures have similar surgery times, complication rates, and recovery periods when both are done laparoscopically.
The practical differences come down to two things. First, salpingectomy offers a much larger reduction in ovarian cancer risk (65% versus 28%). Second, it eliminates the small but real possibility of tubal ligation failure, where a blocked tube reopens or a gap allows sperm to pass through. Because of these advantages, many gynecologists now recommend salpingectomy over traditional tubal ligation when a patient is seeking permanent sterilization.