Male and female sterilisation

Abstract

Male and female sterilisation is used in many countries worldwide as a permanent method of contraception. Failure rates for female sterilisation are affected by age at sterilisation and by the method of tubal occlusion. Laparoscopic sterilisation has low complication rates but is unavailable in parts of the developing world due to the lack of facilities, equipment and expertise. Less invasive techniques are being developed, such as hysteroscopic tubal occlusion and administration of intrauterine agents. Failure rates for vasectomy are 10 times lower than those for female sterilisation. Complications such as pain, haematoma and granuloma formation may occur. Nursing staff and doctors can provide counselling prior to sterilisation. Failure rates, irreversibility, complications and alternative methods of contraception should be discussed and documented. Counselling should allow men and women to provide informed consent for sterilisation and reduce the incidence of regret and requests for reversal.