• Assess the man's:
• Mental capacity to make the decision.
• Level of understanding of the advantages, disadvantages, and relative failure rates of vasectomy and alternative long-term reversible methods of contraception. See Advice and information.
• Risk for later regret. Take additional care when counselling people who are:
• Less than 30 years of age.
• Without children.
• Taking decisions during pregnancy.
• Taking decisions in reaction to the loss of a relationship.
• Possibly at risk of coercion by their partner, family, or health or social welfare professionals.
• Cultural, religious, psychosocial, psychosexual, and psychological issues.
• Risk for sexually transmitted infection and, when appropriate, advise testing, promote safer sex, and/or refer for counselling.
• Assess also the man's partner's suitability for sterilization, as the couple's clinical history, present symptoms, or abnormal examination findings may influence which partner goes forward to have sterilisation.

In depth

• A man who is requesting sterilization should be given advice and written information about:
• The advantages, disadvantages and risks of vasectomy.
• Alternative long-term reversible methods of contraception, including information on the advantages, disadvantages, and relative failure rates of each method.
• Both vasectomy and tubal occlusion.
• The possibility of chronic testicular or scrotal pain after vasectomy.
• The success rates associated with reversal, should this procedure be necessary:
• Men should be informed that the NHS rarely provides reversal operations.
• The need to use effective contraception until azoospermia has been confirmed.
• A man requesting vasectomy can be reassured that:
• Vasectomy does not increase the risk of testicular cancer or heart disease.
• Vasectomy probably does not increase the risk of prostate cancer — any association between vasectomy and prostate cancer is unlikely to be causal.

In depth