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Contraception - Management
UK Medical Eligibility Criteria for male sterilization
The UK Medical Eligibility Criteria are a set of evidence-based recommendations designed to help women and their partners select the most appropriate method of contraception for specific clinical conditions without imposing necessary restrictions [FFPRHC, 2006a]. Each clinical condition has a recommendation for contraceptive use, categorized according to the balance of benefits and harms weighted by their probabilities for the typical user with the condition. The categories are defined in Table 1. Table 2 describes the UK Medical Eligibility Criteria for male sterilization.
Table 1. UK Medical Eligibility Criteria (UKMEC).
Category | Definition |
|---|
UKMEC Accept | There is no medical reason to deny sterilization to a person with this condition. |
UKMEC Caution | The procedure is normally conducted in a routine setting, but with extra preparation, precautions, and counselling. |
UKMEC Delay | The procedure is delayed until the condition is evaluated, treated, and/or changes. Alternative temporary methods of contraception should be provided. |
UKMEC Special | The procedure should be undertaken in a setting with an experienced surgeon and staff, equipment needed to provide general anaesthesia, and other back-up medical support. For these conditions, the capacity to decide on the most appropriate procedure and anaesthesia method is also needed. Alternative temporary methods of contraception should be provided, if referral is required or there is otherwise any delay. |
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Table 2. UK Medical Eligibility Criteria (UKMEC) for male sterilization.
Clinical feature | UKMEC Accept No restrictions | UKMEC Caution Additional preparation | UKMEC Delay Evaluate, treat, or observe | UKMEC Special Specialized staff and facilities required |
|---|
Age | — | Young age (particularly < 30 years) | — | — |
No offspring | — | No offspring | — | — |
Psychological conditions | — | Depressive disorders | — | — |
Infections | High risk of HIV, or HIV-infected | — | Local infections: scrotal skin infection, active STI, balanitis, epididymitis, or orchitis Systemic infection or gastroenteritis | AIDS |
Diabetes | — | Diabetes | — | — |
Haematological conditions | Sickle-cell disease | — | — | Coagulation disorders |
Injuries and surgical conditions | — | Previous scrotal injury Large varicocele Large hydrocele Cryptorchidism* | Filariasis, elephantiasis Intrascrotal mass | Inguinal hernia Cryptorchidism* |
* If cryptorchidism is bilateral and fertility has been demonstrated, extensive surgery will be required to locate the vas, and the procedure becomes category S. If the cryptorchidism is unilateral and fertility has been demonstrated, vasectomy may be performed on the normal side and semen analysis performed, as per routine. If the man continues to have a persistent presence of sperm, more extensive surgery may be required to locate the other vas, and the procedure becomes category S. |
STI = sexually transmitted infection. |
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