4 - Unsuccessful sterilisation

Summary

Introduction

A man or a woman who wishes to forgo parenthood may well opt for voluntary sterilisation. A number of prophylactic sterilisations are, however, performed in the case of those for whom pregnancy would be disastrous but who are, for reasons of mental incapacity, at the same time unable to consent to the operation. Such patients may be sterilised in their best interests – currently described as non-voluntary sterilisation – but to do so is considered such an affront to a woman's autonomy that it may only be done in the United Kingdom by way of a High Court declaration of lawfulness. Such cases are of profound importance in family law but they are beyond the scope of this chapter which is concerned with the failure of sterilisation services rather than their provision.

Negligent sterilisation

Sterilisation in the context of family planning can, of course, be effected by surgery performed on either the male or the female within the partnership. Sterilisation of the male is generally achieved by way of division of the vas deferens on each side. Negligence in the actual operation is very uncommon but there are natural pitfalls. Amongst these are the residual presence of sperm in the distal genital tract – and hence the need for at least two sperm-free ejaculates before unprotected intercourse can be recommended – and recanalisation of the vas, which may occur at any time after the operation due to the formation of granulomas or inflammation tissue.