Male and female sterilization

Male and female sterilization is used in many countries worldwide as a permanent method of contraception. Failure rates for female sterilization are affected by age at sterilization and by the method of tubal occlusion. Laparoscopic sterilization has low complication rates but is not available 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 sterilization. Complications such as pain, haematoma and granuloma formation may occur. Nursing staff and doctors can provide counselling prior to sterilization. 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 sterilization and reduce the incidence of regret and requests for reversal.