Jacobsen Frederik M, Jensen Christian Fuglesang S, Fode Mikkel, Sønksen Jens, Ohl Dana A
Department of Urology, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
Department of Urology, University of Michigan, Ann Arbor, MI, USA.
Eur Urol Open Sci. 2020 Nov 20;22:74-78. doi: 10.1016/j.euros.2020.10.006. eCollection 2020 Dec.
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.
To compare patient compliance for PVSA when scheduling appointments as opposed to a "drop-in" appointment 8-16 wk after the procedure.
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.
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.
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.
Scheduling appointments for PVSA has no impact on compliance rates or the time between vasectomy and semen analysis when compared with "drop-in" appointments.
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.
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。
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。
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。
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。
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。
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。
