Male and female sterilisation

Male and female sterilisation are important forms of contraception worldwide despite declining popularity in developed countries. Vasectomy is the only highly reliable form of male contraception. Appropriate counselling about permanent methods of contraception in both sexes is vital and should include information about irreversibility, failure rates and complications. The alternatives to sterilisation, particularly Long Acting Reversible Contraception (LARC) should be discussed in detail as they are at least as effective or more effective and have the advantage of reversibility. Hysteroscopic rather than laparoscopic techniques for female sterilisation are more cost effective but are limited in their availability. In males the no-scalpel technique vasectomy requires minimal operating time and results in less post-operative discomfort than the incisional method. Regret after sterilisation and requests for reversal are more common in patients under 30 years and in men with no children.