MALE SURGICAL STERILIZATION
Sterilization does not protect against sexually transmitted infections (STIs), including HIV. If there is a risk of STI/HIV, the correct and consistent use of condoms is recommended. When used correctly and consistently, condoms offer one of the most effective methods of protection against STIs, including HIV. Female condoms are effective and safe, but are not used as widely by national programmes as male condoms.
CONDITION
* additional comments after this table		CATEGORY a
A = accept, C = caution,
D = delay, S = special		CLARIFICATIONS/EVIDENCE
PERSONAL CHARACTERISTICS AND REPRODUCTIVE HISTORY
YOUNG AGECClarification: Young men, like all men, should be counselled about the permanency of sterilization and the availability of alternative, long-term, highly effective methods.

Evidence: Men who underwent vasectomy at young ages were more likely to have the procedure reversed than those who underwent vasectomy at older ages (2).
DEPRESSIVE DISORDERS
DEPRESSIVE DISORDERSC
HIV/AIDS
HIGH RISK OF HIVAClarification: No routine screening is needed. Appropriate infection prevention procedures, including universal precautions, must be carefully observed with all surgical procedures. The use of condoms is recommended following sterilization.
ASYMPTOMATIC OR MILD HIV CLINICAL DISEASE
(WHO STAGE 1 OR 2)		AClarification: No routine screening is needed. Appropriate infection prevention procedures, including universal precautions, must be carefully observed with all surgical procedures. The use of condoms is recommended following sterilization.
SEVERE OR ADVANCED HIV CLINICAL DISEASE
(WHO STAGE 3 OR 4)		SClarification: The presence of severe or advanced HIV clinical disease may require that the procedure be delayed.
ENDOCRINE CONDITIONS
DIABETES*CClarification: If blood glucose is not well controlled, referral to a higher-level facility is recommended.
ANAEMIAS
SICKLE CELL DISEASE*A
OTHER CONDITIONS RELEVANT ONLY FOR MALE SURGICAL STERILIZATION
LOCAL INFECTION*
a) Scrotal skin infectionD
b) Active STID
c) BalanitisD
d) Epididymitis or orchitisD
COAGULATION DISORDERS*S
PREVIOUS SCROTAL INJURYC
SYSTEMIC INFECTION OR GASTROENTERITIS*D
LARGE VARICOCELE*C
LARGE HYDROOCELE*C
FILIARIASIS; ELEPHANTIASIS*D
INTRASCROTAL MASS*D
CRYPTORCHIDISMS
INGUINAL HERNIA*S
a

Further explanation of A, C, D and S categories:

  • A = accept: There is no medical reason to deny sterilization to a person with this condition.
  • C = caution: The procedure is normally conducted in a routine setting, but with extra preparation and precautions.
  • D = delay: The procedure is delayed until the condition is evaluated and/or corrected. Alternative temporary methods of contraception should be provided.
  • S = special: The procedure should be undertaken in a setting with an experienced surgeon and staff, equipment needed to provide general anaesthesia, and other back-up medical support. For these conditions, the capacity to decide on the most appropriate procedure and anaesthesia regimen is also needed. Alternative temporary methods of contraception should be provided if referral is required or there is otherwise any delay.

From: II, Using the recommendations

Cover of Medical Eligibility Criteria for Contraceptive Use
Medical Eligibility Criteria for Contraceptive Use. 5th edition.
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