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安排输精管切除术后精液分析的预约对依从性没有影响。

Scheduling Appointments for Postvasectomy Semen Analysis Has No Impact on Compliance.

作者信息

Jacobsen Frederik M, Jensen Christian Fuglesang S, Fode Mikkel, Sønksen Jens, Ohl Dana A

机构信息

Department of Urology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.

Department of Urology, University of Michigan, Ann Arbor, MI, USA.

出版信息

Eur Urol Open Sci. 2020 Nov 20;22:74-78. doi: 10.1016/j.euros.2020.10.006. eCollection 2020 Dec.

Abstract

BACKGROUND

A postvasectomy semen analysis (PVSA) is recommended 8-16 wk after vasectomy to ensure azoospermia. Patient compliance with submitting a semen sample for PVSA has historically been low. To increase patient compliance, a policy change was made to schedule patients for PVSA appointments instead of a previous "drop-in" option.

OBJECTIVE

To compare patient compliance for PVSA when scheduling appointments as opposed to a "drop-in" appointment 8-16 wk after the procedure.

DESIGN SETTING AND PARTICIPANTS

Ethical approval was obtained to retrospectively evaluate patients undergoing vasectomy. A total of 400 patients were evaluated, 200 consecutive patients before and 200 after the policy change. Patients were excluded from analysis if they had other surgeries at the same time of vasectomy or if the vasectomy was a repeat procedure.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

Percent of patients attending PVSA and time to PVSA were assessed. Nominal data were compared using chi-square analysis and interval data were compared using Student unpaired test.

RESULTS AND LIMITATIONS

Thirteen patients were excluded from analysis: six before and seven after the policy change. Compliance rates were similar before and after the policy change (144/194 [74%] and 154/193 [80%],  = 0.19). There was no difference in the time from vasectomy to PVSA between groups (before: mean [standard deviation] 69 [55] d vs after: 74 (63) d,  = 0.44). This study is limited by its retrospective design.

CONCLUSIONS

Scheduling appointments for PVSA has no impact on compliance rates or the time between vasectomy and semen analysis when compared with "drop-in" appointments.

PATIENT SUMMARY

Sterility after a vasectomy is guaranteed by delivering a semen sample. Many men do not deliver this sample, and sterility cannot be guaranteed. This study found that scheduling appointments did not increase the number of men who delivered a semen sample compared with "drop-in" appointments.

摘要

背景

输精管结扎术后精液分析(PVSA)建议在输精管结扎术后8 - 16周进行,以确保无精子症。以往患者提交PVSA精液样本的依从性较低。为提高患者依从性,政策发生了改变,为患者安排PVSA预约,而非之前的“随时来”选项。

目的

比较输精管结扎术后8 - 16周安排预约与“随时来”预约时患者进行PVSA的依从性。

设计、地点和参与者:获得伦理批准以回顾性评估接受输精管结扎术的患者。共评估了400例患者,政策改变前连续200例患者,政策改变后200例患者。若患者在输精管结扎术同时进行了其他手术,或输精管结扎术为重复手术,则排除在分析之外。

结果测量和统计分析

评估患者参加PVSA的百分比和PVSA的时间。使用卡方分析比较名义数据,使用学生非配对t检验比较区间数据。

结果和局限性

13例患者被排除在分析之外:政策改变前6例,政策改变后7例。政策改变前后的依从率相似(144/194 [74%] 和154/193 [80%],P = 0.19)。两组从输精管结扎术到PVSA的时间无差异(之前:平均[标准差]69 [55]天,之后:74 [63]天,P = 0.44)。本研究受其回顾性设计的限制。

结论

与“随时来”预约相比,为PVSA安排预约对依从率或输精管结扎术与精液分析之间的时间没有影响。

患者总结

输精管结扎术后通过提交精液样本可确保不育。许多男性未提交该样本,不育无法得到保证。本研究发现,与“随时来”预约相比,安排预约并未增加提交精液样本的男性数量。

相似文献

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Patient noncompliance after vasectomy.输精管切除术后患者的不依从性。
Fertil Steril. 1997 Sep;68(3):552-5. doi: 10.1016/s0015-0282(97)00251-3.

本文引用的文献

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Evaluation of Vasectomy Trends in the United States.美国输精管切除术趋势评估
Urology. 2018 Aug;118:76-79. doi: 10.1016/j.urology.2018.03.016. Epub 2018 Mar 22.
8
Compliance with semen analysis.精液分析的依从性。
J Urol. 2013 Jun;189(6):2248-51. doi: 10.1016/j.juro.2013.01.062. Epub 2013 Jan 25.
9
Vasectomy: AUA guideline.输精管切除术:AUA 指南。
J Urol. 2012 Dec;188(6 Suppl):2482-91. doi: 10.1016/j.juro.2012.09.080. Epub 2012 Oct 24.
10
European Association of Urology guidelines on vasectomy.欧洲泌尿外科学会输精管切除术指南。
Eur Urol. 2012 Jan;61(1):159-63. doi: 10.1016/j.eururo.2011.10.001. Epub 2011 Oct 19.

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