No Scalpel Vasectomy Australia Position Statement: Covid-19
· Vasectomy is a permanent contraceptive method, safer and more effective than all other forms of contraception.
· It is a minor elective procedure which should be performed under local anaesthetic as an office-based procedure.
· The routine use of sedation or general anaesthetic is not indicated
· Office-based vasectomy services minimises the use of essential PPE
In the Covid-19 pandemic climate delivering vasectomy services may be seen as a very important health service by some couples as an option for family planning and contraception. Similarly, in an economic sense, for providers and associated organisations it may be seen as an important income stream to maintain financial and operational sustainability.
On the other hand, vasectomy services, unlike abortion care, are not ‘Category 1’ or emergency surgery and financial imperatives should not override community care and safety considerations.
Vasectomy, especially being a permanent method of contraception, requires counselling. This can take a considerable time dependent on the provider’s practice ranging up to a separate long consultation (Item 36). This usual face to face pre-operative counselling significantly increases the risk of Covid-19 transmission. Fortunately, the introduction of telehealth item numbers can be used to minimise this risk and the need for use of PPE.
The vasectomy process involves reception staff who need to be protected with a degree of PPE.
The operation including the setup and post-operative phases involves at a minimum contact with the doctor and possibly a nurse. The actual operation time varies from as little as 6 minutes to an hour. Currently the minimum PPE required would be P2/N95 masks for the patient and doctor, a long sleeve impervious gown and face shield or goggles for the doctor given the close contact.
On balance NSVA, at this time, recommends the cessation of all office-based vasectomy services.