Sterilisation

Question 1

What are the failure rates of male and female sterilisation?

Answer 1

1. 0.5% (1 in 200)

2. 0.05% (1 in 2000)

Question 2

What is the method for female sterilisation?

Answer 2

Laparoscopic clipping of the fallopian tubes under general anaesthetic or hysteroscopic insertion of fallopian implants.

Question 3

What are the disadvantages of female sterilisation?

Answer 3

1. If pregnancy does occur, more likely to be ectopic
2. NHS will not fund reversal, by no means successful (50%).
3. If on COCP long term before, may get menorrhagia after.

Question 4

What is the method for male sterilisation?

Answer 4

Vas deferens ligated under local anaesthetic as an outpatient, more effective than female sterilisation.

Question 5

What are the disadvantages of male sterilisation?

Answer 5

1. Bruising, haematoma, and infection
2. Risk of chronic testicular pain
3. Takes 3 months to be effective

Question 6

How is male sterilisation confirmed as successful?

Answer 6

1. Obtain 2 negative ejaculates

2. 1st at 8 weeks, 2nd 4 weeks later, then stop contraception.

Question 7

What are the important points for counselling for sterilisation (OSCE station)?

Answer 7

1. Patient must be certain it is what they want
2. Discuss alternative contraception
3. Risk of surgery and general anaesthetic for women
4. NHS will not fund reversal
5. Increased risk of ectopic
6. Seek medical help if pregnancy suspected or vaginal bleeding