Dahm F, Dahm P, Dahm J
Urologische Praxis, Wörth am Rhein.
Urologe A. 2003 Jul;42(7):933-9. doi: 10.1007/s00120-003-0301-z. Epub 2003 Feb 18.
We report on a large series of 1,275 patients who underwent outpatient vasectomy performed by a single urological surgeon within a 10-year period. In addition, the results of a prospective questionnaire-based study on 217 patients regarding their opinions and motivation, and the financial aspects of the vasectomy are discussed. The mean age was 37.0+/-5.9 years. A total of 98.4% of the patients had an uneventful postoperative course. The average duration of sick leave was 2.2+/-0.21 days. During the study period, the length of sick leave dropped significantly from 2.63 (1990/91) to 1.1 days (1998/99; P=0.001). Efficacy was documented with azoospermia rates of 96.6% and 98.5% in patients who presented for two and three sperm examinations, respectively. A vast majority of patients (94.6%) felt that the procedure should be covered by their health insurance, although 88.1% stated they would also pay by themselves. A minority of patients (0.7%: 9/1,275) subsequently considered vasectomy reversal. The wish to reverse the vasectomy was significantly associated with a younger patient age. In conclusion, outpatient vasectomy provides a safe and reliable form of contraception at low cost. Overall satisfaction in appropriately counselled patients is very high. Based on these findings, further attempts to propagate vasectomy as a timely form of contraception are medically and socioeconomically recommended.
我们报告了由一名泌尿外科医生在10年期间为1275例患者实施门诊输精管结扎术的大宗病例。此外,还讨论了一项基于问卷的前瞻性研究结果,该研究涉及217例患者对输精管结扎术的看法、动机以及费用方面的情况。患者的平均年龄为37.0±5.9岁。共有98.4%的患者术后过程顺利。平均病假天数为2.2±0.21天。在研究期间,病假天数从1990/91年的2.63天显著降至1998/99年的1.1天(P=0.001)。在分别进行两次和三次精液检查的患者中,无精子症发生率分别为96.6%和98.5%,证明了手术的有效性。绝大多数患者(94.6%)认为该手术应由医疗保险支付,尽管88.1%的患者表示他们也会自行付费。少数患者(0.7%:9/1275)随后考虑进行输精管复通术。希望进行输精管复通术与患者年龄较轻显著相关。总之,门诊输精管结扎术提供了一种安全可靠且低成本的避孕方式。在接受适当咨询的患者中,总体满意度非常高。基于这些发现,从医学和社会经济角度建议进一步努力推广输精管结扎术作为一种适时的避孕方式。