Community-based vasectomy services: from medical to holistic care

K. McAllister

The Sandyford Initiative, Glasgow, UK

Introduction: The vasectomy service within the Sandyford Initiative, Reproductive and Sexual Health Centre, Glasgow has traditionally been medically-led, with medical staff performing both the counselling and operating sessions. It was felt that the service could be more holistically driven, by improving the surroundings and increasing the input from family planning nurses.

Method: Five designated FP nurses attended in-house training, to give them an overview of the procedure, it’s complications and failure rates and completed a short supervised practice session prior to staffing individual clinics. The nurses counselled the client and obtained written consent, but did not perform scrotal examination. ‘De-medicalisation’ during the procedure itself was also improved with background music and, after consultation with the Trust infection control team, green operating gowns were replaced with plastic aprons and no masks were worn. Clients were audited during a one-month period for their views on the counselling and operative visit.

Results: 66 attended for counselling all of which completed questionnaires (100%). All reported the reception and counselling staff to be courteous with the length of appointment (20 mins) adequate and the information given comprehensive. 43 had a female nurse counsellor and all felt comfortable with this. 85 attended for vasectomy and all completed questionnaires (100%). 83 felt the counselling prepared them for the procedure with 27 stating the discomfort was as expected, 53 less and 5 worse than expected. All clients who wished background music (30) felt it was useful in distracting them but only 4 of the 23 clients who chose not to have background music felt afterwards that it may have been useful. 5 clients asked for their partners to be present and this was agreed by the surgeon involved.

Conclusion: It is possible to provide a more holistic vasectomy service without compromising on the level of medical care received. The introduction of a nurse led vasectomy counselling service in a holistic setting led to a high level of client satisfaction.