STERILIZATION: SENSIBLE CHOICE OR SERIOUS TROUBLE? – A SUCCESSFUL OUTCOME? (CONCLUSION)
Even a fairly routine interview must be undertaken skilfully, for there are few other areas of medical practice where one meets patients who feel so strongly that the ultimate decision must be theirs. The anger and frustration they can feel if they think they have been denied the freedom to make the decision themselves has been described graphically (Law, 1982). It is worth telling the couple that the ultimate decision is theirs, and the interview has been set up to discuss both the correct timing for the operation and to identify any problems which may arise afterwards.
It would not be particularly revealing to analyse the feelings of couples who are happy with the outcome of their sterilization, although they are in the vast majority. It can, however, be salutary to look at the events which led to an operation being arranged which later proved to have been a disaster for the individuals concerned. In most instances, contraindications to sterilization were overlooked because of other priorities. There should be doubts over the wisdom of sterilization if the individual is young, that is, under 30 years, or has marital problems. Caution should be exercised if there is serious illness in either partner or if the individual seems not to grasp that the operation is irreversible. The great majority of people who present with regrets are those who gave consent at too young an age (Wilcox, Chu, Eaker et al., 1991; Winston, 1977). In these instances the operation was usually undertaken because the woman concerned was unable or unwilling to use reversible contraception effectively. The first of these reasons is more typical, and underlines the need for doctors who are skilful and knowledgeable about contraception, and who are prepared to work with the patient, often over a period of some time, in order to help her to find a method to suit her.
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Tags: Erectile Dysfunction, Men’s Health