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J R Soc Med. 2002 January; 95(1): 56–57.
PMCID: PMC1279167

Counselling and consent in vasectomy

The paper by Mr Harris and Mr Holmes (October 2001, JRSM, pp. 510-511) gets off to a poor start by citing the uptake of vasectomy in the UK as 23%. In fact, the BMJ leader by Roberts1 they quote from states that this is the figure for male and female sterilization combined; the source of information is the 1998 General Household Survey for Great Britain and comprises female sterilization at 11% and vasectomy at 12%2. The figure of 12% is derived from women aged 16-49 interviewed about their partners. When men themselves are surveyed the figure is 17% of men aged 16-693.

I am not sure if the authors have read the national guidelines4 announced in the BMJ leader. These guidelines were produced after a full-blown 18-month Department of Health sponsored procedure including urological, medicolegal and consumer representation and involving a systematic review of the literature followed by peer review. The following points are included in these guidelines and are contrary to statements made by the authors.

  • Men should be given information on the success rates associated with reversal should this procedure be necessary
  • Post-vasectomy semen analyses should be carried out two to four weeks apart, with the first test at least eight weeks after surgery

The guidelines also contain a new consent form to be used. Division of the vas alone is not regarded as an acceptable surgical technique: the recommendation is that it should be accompanied by fascial interposition or diathermy.

Furthermore the importance of the use of written information when counselling couples is emphasized and criteria to be covered in counselling are spelled out to minimize the chance of subsequent regret.

References

1. Roberts H. Good practice in sterilisation. BMJ 2000;320: 662-3 [PMC free article] [PubMed]
2. Bridgwood A. Contraception. In: Living in Britain: Results from the 1998 General Household Survey. London: Stationery Office, 2000: 164-77
3. Dawe F, Meltzer H. Contraception and Sexual Health 1999. London: Office for National Statistics, 2001
4. Royal College of Obstetricians and Gynaecologists. Male and Female Sterilisation: Evidence-based Clinical Guidelines, No. 4. London: RCOG Press, 1999

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press