• male contraception
• vasectomy
• family planning service provision

We thank Drs Chukwu and Menon¹ for their interest in our article,² and are pleased to hear that their DVD is as popular with patients as ours is.

We also started out requiring men who had a history of previous scrotal surgery to come for an appointment prior to their vasectomy. This was in order to carry out an examination to check that the procedure was likely to be possible under local anaesthetic. However, we subsequently analysed this practice and discovered that those men were no more likely to have a failed procedure than those who had no previous history of scrotal surgery, and so we now allow this group of patients also to bypass the preoperative appointment.

Patients who have had failed vasectomy are seen for a consultation prior to repeat procedure, as in Drs Chukwu and Menon's practice. Men with a self-diagnosed testicular mass, and also those under the age of 28 years and those on warfarin, are also required to attend for a clinic appointment prior to being listed for their vasectomy. In addition, the DVD offers an outpatient appointment to any patient who wishes to discuss vasectomy with a clinician.