Vasectomy

Scope

This guideline covers the assessment, counselling and procedural considerations for male sterilisation options.

Out of Scope

It does not include reversible contraceptive options.

Background:
  • Sterilisation is a common method of contraception worldwide
  • Requests for sterilisation should come from the patient and be considered irrespective of marital status
  • It is recommended that all patients undergo careful counselling and this process is documented when obtaining informed consent
  • Information should be delivered with respect for the religious and cultural beliefs of the patient
  • Sterilisation is a subject of intense medico-legal activity; therefore it is important to clearly document all aspects of the clinical history, examination, counselling and consent process
Advantages:
  • Concealed method
  • Cost effective contraception
  • Not dependent on patient compliance
  • No significant long-term adverse effects
  • Does not interfere with intercourse

Assessment

History and Examination

The following criteria are essential when assessing suitability for sterilisation:

  • Patient has chosen permanent contraception
  • Patient is competent to make a choice
  • Patient is a suitable candidate for surgery (consider using World Health Organization [WHO] medical eligibility criteria to assess suitability)

Patients with the following criteria may not be suitable for sterilisation
Increased likelihood of regret:

  • Under age 30 years
  • Few or no children
  • Unstable relationship
  • Diminished mental capacity
  • Suspected coercion
  • Insufficient time to consider decision

Management

If patient is unsuitable for a vasectomy, discuss alternative methods of contraception

Referral

Referral Criteria

All patients will be offered referral to a primary care service for a vasectomy under local anaesthetic (LA). There are some patients who may require general anaesthetic (GA); often these patients will be assessed in primary care first.

Please include in referral letter:

  • BMI
  • Previous testicular surgery
  • Patients receiving anticoagulant treatment
  • History of allergy to local anaesthetic

Referral Instructions

e-Referral service selection

  • Speciality: Urology
  • Clinic Type: Vasectomy
  • Service: DRSS-South Devon & Torbay-Vasectomy- Devon CCG - 15N

Referral Forms

DRSS referral form

Supporting Information

Patient Information

IDH Group – Kinskerswell Health Centre

Clare House service at Dawlish Hospital

Pathway Group

This guideline has been signed off by South Devon & Torbay locality on behalf of NHS Devon CCG

Publication date: July 2017

 

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