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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
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
If patient is unsuitable for a Vasectomy, discuss alternative methods of contraception
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-Eastern-Urology- Devon ICB- 15N
Referral Form
Patient Information
Exeter Medical patient leaflet
Pathway Group
This guideline has been signed off on behalf of NHS Devon.
Publication date: February 2016
