Contraception - Male And Female Sterilisation Flashcards Preview

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Flashcards in Contraception - Male And Female Sterilisation Deck (52)
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What is sterilisation?

A surgical means of obtaining permanent contraception


How does sterilisation work?

By occluding the Fallopian tubes in women, and vas deferens in women


What documentation should be done before performing sterilisation?

- Consent form should be signed
- Clear documentation about discussion, information given, and any requests made by the individual


What specific issues need to be covered when obtaining consent for sterilisation?

- Failure rate
- Irreversibility
- Time constraints
- Choice of procedure
- Alternative options
- Limitations


Is sterilisation irreversible?

Yes (well no, but should be seen as an irreversible procedure)


What should the patient be told regarding reversal options for sterilisation?

- Success rate as defined by successful pregnancy is very limited
- Operation is not available on the NHS


When is female sterilisation effective from?

Woman is sterile immediately after operation, but can conceive in pre-operative menstrual cycle


What should the woman be advised regarding being able to conceive in the pre-operative menstrual cycle?

She should avoid sex or use effective contraception until menstrual period following operation


When is a man considered sterile after the operation?

Should not be considered sterile until semen samples with no spermatozoa have been confirmed


When should the man receive a semen sample with no spermatozoa?

Usually 12-16 weeks after the operation


What may be required when confirming a man is sterile after vasectomy?

1 or 2 tests


What should couples be advised of regarding choice of sterilisation procedure?

Vasectomy carries fewer risks as a procedure, and has a lower failure rate in terms of unwanted pregnancies


What alternative options are there to sterilisation?

Long-acting reversible methods of contraception


Give a limitation of sterilisation

Does not protect against STIs


What should ideally happen with counselling for sterilisation?

The couple should be seen and counselled together


What does the patient and their partner need to understand before proceeding with sterilisation?

Need to understand that sterilisation is irreversible


What theoretical situation can be used to ensure the couple are sure about sterilisation?

Even if tragedy were to befall their family, neither would wish to have more children


What things should be considered to reduce regret caused by sterilisation?

- Age
- Family structure
- Relationship stability
- Timing


What age groups are more likely to regret sterilisation?

Young people, especially under 30


What family structures are more likely to experience regret?

Couples with fewer than 2 children


What is there a risk of when a relationship breaks down with sterilisation?

Risk the sterilised partner will wish to have children with a new partner in a new relationship


What should be considered regarding timing of sterilisation?

- Tubal occlusion should be performed after an appropriate interval following pregnancy
- Tubal ligation can be performed at C-section
- Vasectomy in the partners pregnancy should be approached with care


Why should vasectomy during a partners pregnancy be approached with care?

Even if current pregnancy is unplanned, stillbirth and neonatal death can still occur, so better to wait until healthy child is delivered and is several weeks old


What should be done if tubal ligation is performed at C-section?

The obstetrician should ascertain that the paediatrician is happy the baby is healthy before proceeding


What is the limitation of checking that the baby is healthy before proceeding with tubal ligation at C-section?

Problems may not be apparent immediately


When should consent and counselling take place if tubal ligation is to be done at C-section?

At least 2 weeks before the procedure


What is the aim of vasectomy?

Interruption of vas deferens


What anaesthetic is used for vasectomy?



Describe the procedure for vasectomy

The vas deferens is exposed and isolated, and then the lumen is occluded and the vas deferens divided


How is the success of vasectomy confirmed?

Post-operative semen analysis to confirm azoospermia