Standard of vasectomy counselling in a sexual health clinic
A. Brockmeyer and A. Webb
Abacus Clinics, Liverpool, UK
Background Abacus
Clinics in Liverpool, UK, offer vasectomy counselling and subsequent referral
for vasectomy. Male and female sterilisations attract the highest number of
medical litigations. Several recent studies looked at the counselling process
and documentation for female sterilisation but so far no analysis has been done
for male sterilisation. The Royal College of Obstetricians and Gynaecologists (RCOG)
published new guidelines regarding female and male sterilisation in 2004. These
include expected standards for the counselling process.
Objectives to compare
the standard of vasectomy counselling at Abacus Clinics with the standards of
the RCOG.
Methodology Retrospective audit. All information material related to
vasectomy, the counselling and consent forms used at Abacus Clinics were
analysed and compared with the recommendations of the RCOG. For each doctor
involved in vasectomy counselling 5 counselling notes were analysed.
Results Twenty-five vasectomy counselling records from May 2004 till November 2004 were reviewed. In
general, recorded information was sparse. Long term complications were not
documented by any of the doctors. Documentation was not helped by the layout of
the vasectomy counselling form which did not leave much room for history taking.
The vasectomy information leaflet mentioned almost all the counselling points
recommended by the RCOG. The consent form was outdated and did not follow the
national guidelines for taking consent. Advice regarding appropriate
documentation was sought from a medical defence organisation but still left
questions about the extent of documentation necessary. As a result of this audit,
we changed the consent form for vasectomy and part of the counselling form. We
also drew up guidelines for vasectomy counselling and training standards for
doctors.
Conclusion Vasectomy is one of the most commonly performed operations
in the UK which attracts a high number of litigation cases. Detailed counselling
is essential. Although guidelines for vasectomy counselling are available there
is only limited advice on necessary documentation.