Case-based learning| Volume 25, ISSUE 5, P128-132, May 2015

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Male and female sterilization

Published:March 14, 2015DOI:


      Male and female sterilization are important forms of contraception worldwide despite declining popularity in developed countries. Vasectomy is the only highly reliable form of male contraception. Appropriate counselling about permanent methods of contraception in both sexes is vital and should include information about irreversibility, failure rates and complications. The alternatives to sterilization, particularly Long Acting Reversible Contraception (LARC) should be discussed in detail as they are at least as effective or more effective and have the advantage of reversibility. Hysteroscopic rather than laparoscopic techniques for female sterilization are more cost effective but are limited in their availability. In males the no-scalpel technique vasectomy requires minimal operating time and results in less post-operative discomfort than the incisional method. Regret after sterilization and requests for reversal are more common in patients under 30 years and in men with no children.


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      Further reading

        • Royal College of Obstetricians & Gynaecologists
        Male and female sterilisation. National evidence-based clinical guideline number 4.
        RCOG Press, London2004
        • Royal College of Obstetricians & Gynaecologists
        Laparoscopic injuries. Green Top Guideline 49.
        RCOG Press, London2008
        • Royal College of Obstetricians & Gynaecologists
        Laparoscopic tubal occlusion. Consent advice 3.
        RCOG Press, London2004
        • Royal College of Obstetricians and Gynaecologists
        The distal fallopian tube as the origin of non-uterine pelvic high-grade serous carcinomas. Scientific impact paper 44.
        RCOG Press, LondonNovember 2014
        • National Institute for Health & Care Excellence
        Interventional procedure overview of hysteroscopic sterilisation by tubal cannulation and placement of intrafallopian implant.
        NICE, London2009
        • Duffy S.
        • Marsh F.
        • Rogerson L.
        • et al.
        Female sterilisation: a cohort controlled comparative study of ESSURE versus laparoscopic sterilisation.
        BJOG. 2005; 112: 1522-1528
        • Guidelines on vasectomy
        European association of urology.
        Eur Urol. 2012; 61 (61(2011)): 159-169
      1. Vasectomy, World Health organization essential surgical care manual.

        • Cook L.A.
        • Pun A.
        • Gallo M.F.
        • Lopez L.M.
        • Van Vliet H.A.A.M.
        Scalpel versus no-scalpel incision for vasectomy.
        Cochrane Database Syst Rev. 2007; (Issue 2. Art. No.: CD004112)
        • National Institute for Health & Care Excellence
        Long-acting reversible contraception.
        NICE, London2005
        • National Institute for Health & Care Excellence
        Contraception services with a focus on young people up to the age of 25.
        NICE Public Health Guidance 51, 2014