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COPYRIGHT 2004 CMP Information Ltd.
Manish Gupta and Dr Kirsten Duckitt examine the latest guidelines
Sterilisation can be an empowering event for a woman or man when carried out at the right time in a person's life. But its success should not detract us from giving all the information we can to the patient so they make an informed choice.
The Royal College of Obstetricians and Gynaecologists has recently updated its evidence-based guideline for male and female sterilisation. This article examines aspects relevant to GPs and their patients.
What needs to be discussed?
As well as the usual history and examination, everyone who requests sterilisation must be counseled regarding other long-term, reversible methods of contraception. This should include information on the advantages, disadvantages and relative failure rates of each method (see table top right). Women in particular should be informed that vasectomy for their partner is safer and more effective than tubal occlusion.
At this point it is a good idea to remind people that contraception still needs to be used up until the next period following the procedure for women. For men, they or their partners will need to use effective contraception until azoospermia has been confirmed by semen analysis at least eight weeks after the vasectomy. In the UK this is usually confirmed by two separate post-vasectomy samples. This is to confirm that there is clearance of stored spermatozoa and to ensure there is no evidence of...
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