Standards for Female and Male Sterilization Services - STATE ...

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74Standards for female and male Sterilization servicesAnnexure 7Medical Eligibility Criteria for Male SurgicalSterilization(Source: Medical Eligibility Criteria for Contraceptive Use, Third Edition, WHO, 2004)There are no absolute contraindications for performing a sterilization operation.However, there are certain relative contraindications where one needs to apply thecriteria of ‘A’, ‘C’, ‘D’, and ‘S’ as stated below.A Accept There is no medical reason to deny sterilization to a person with this condition.C Caution The procedure is normally conducted in a routine setting, but with extra preparationand precautions.D Delay The procedure is delayed until the condition is evaluated and/or corrected. Alternativetemporary methods of contraception should be provided.S Special The procedure should be performed by an experienced surgeon and staff, in a settingwhere equipment for providing general anaesthesia and other back-up medical supportis available. To meet these conditions, the capacity to decide on the most appropriateanaesthesia regimen is also needed. Alternative temporary methods of contraceptionshould be provided, if referral is required or if there is otherwise any delay.Condition Category Clarification/EvidencePersonal characteristics and reproductive historyYoung age C Clarification: Young men, like all men, should be counselled aboutthe permanency of sterilization and the availability of alternative, longterm,and highly effective methods.Evidence: Men who underwent vasectomy at young ages were morelikely to have the procedure reversed than those who underwentvasectomy at older ages.Depressive disordersDepressive disorders CHIV/AIDSHigh risk of hivHiv infectedAAClarification: No routine screening is needed. Appropriate infectionpreventionprocedures, including universal precautions, must beobserved carefully with all surgical procedures. The use of condoms isrecommended following sterilization.
Standards for female and male Sterilization services 75Condition Category Clarification/EvidencePersonal characteristics and reproductive historyAids S Clarification: The presence of an AIDS-related illness may require adelay in the procedure.Endocrine conditionsDiabetes*CAnaemiasSickle-cell disease AOther conditions relevant only for male surgical sterilizationLocal infections*a) scrotal skininfectionb) active STIc) balanitisd) epididymitis ororchitisCoagulationdisorders*Previous scrotal injurySystemic infection orgastroenteritis*Large varicocele*Large hydrocele*Filariasis;Elephantiasis*Intrascrotal mass*DDDDSCDCCDDCryptorchidism C Clarification: If the cryptorchidism is bilateral and fertility has beendemonstrated, it will require extensive surgery to locate the vas, andthis becomes category ‘S’. If the cryptorchidism is unilateral andfertility has been demonstrated, vasectomy may be performed onthe normal side and semen analysis performed as per the routine.If the man continues to have a persistent presence of sperm, moreextensive surgery may be required to locate the other vas, and thisbecomes category ‘S’.Inguinal hernia* S* See Additional Comments
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DR. (SMT.) M.S. JayalakshmiDeputy C
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