Standard of vasectomy counselling in a sexual health clinic

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 The consent form was outdated and did not follow the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


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.

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