Division of Family Medicine, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, Cape Town.
S Afr Fam Pract (2004). 2024 Oct 4;66(1):e1-e8. doi: 10.4102/safp.v66i1.6003.
Our study focuses on vasectomies, an underutilised contraception method worldwide. Little is known about post-vasectomy semen analysis (PVSA) adherence in our setting, which is an essential step in confirming the procedure's success. We aimed to describe patient adherence to post-vasectomy follow-up and the success of procedures performed by different surgeon categories at three Cape Town district health facilities.
We conducted a retrospective descriptive audit. We extracted sociodemographic and procedural information from theatre records and patient folders. The PVSA results were retrieved from Groote Schuur Hospital's Reproductive Medicine Unit.
The records of 270 patients who underwent vasectomies in local district-level facilities from September 2016 to July 2021 were included. Only 122 (45.2%) semen analysis results were retrievable, of which 115 (94.2%) showed that the procedure was successful. Incomplete patient records significantly impacted the study. A data-collection instrument and implementing standardised stationery were developed, which some sites already use. These measures are designed to ensure more comprehensive datasets for future audits.
The study's findings have identified flaws in record-keeping practices at the three study sites, a crucial step towards improving post-vasectomy care. Tracking procedural success and patient adherence to post-vasectomy semen analyses using the implemented stationery may assist future research and help drive quality improvement projects.Contribution: This audit strengthens our understanding of improving this underutilised family planning option in the district health services. In partnership with the local teams, a revised clinical care pathway was developed to inform the delivery of an evidence-informed vasectomy service.
我们的研究聚焦于输精管切除术，这是一种在全球范围内未得到充分利用的避孕方法。在我们的环境中，很少有人了解输精管切除术后精液分析（PVSA）的依从性，这是确认手术成功的重要步骤。我们旨在描述患者在三个开普敦地区卫生机构对输精管切除术后随访的依从性以及不同外科医生类别进行的手术的成功率。
我们进行了回顾性描述性审计。我们从手术室记录和患者文件夹中提取了社会人口统计学和程序信息。PVSA 结果从格罗特舒尔医院生殖医学科获取。
共纳入了 2016 年 9 月至 2021 年 7 月在当地地区一级医疗机构接受输精管切除术的 270 名患者的记录。仅可检索到 122 份（45.2%）精液分析结果，其中 115 份（94.2%）显示手术成功。不完整的患者记录严重影响了研究。已经开发了一种数据收集工具和实施标准化文具，一些站点已经在使用。这些措施旨在确保未来审计有更全面的数据集。
该研究发现了三个研究地点在记录保存实践中的缺陷，这是改善输精管切除术后护理的重要一步。使用实施的文具跟踪程序成功率和患者对输精管切除术后精液分析的依从性，可能有助于未来的研究并有助于推动质量改进项目。
这项审计加强了我们对改善地区卫生服务中这种未充分利用的计划生育选择的理解。与当地团队合作，制定了修订后的临床护理途径，为提供基于证据的输精管切除术服务提供信息。
