Degraeve Amandine, Tosco Lorenzo, Tombal Bertrand, Roumeguere Thierry, Beirnaert Jeanne, Hamal Robin, Bugli Céline, Cosentino Marco, Gin Don Lee Wai, Skrodzka Marta, Albersen Maarten, van Renterghem Koenraad, Sempels Maxime, Penning David, Fode Mikkel, Faix Antoine, Waterloos Marjan, Gomez Borja Garcia, Carnicelli Damien, Graziana Jean-Pierre, Morgado Afonso, D'Hauwers Kathleen, Serefoglu Ege, Manfredi Celeste, Weyne Emmanuel, Beck Jack, Osmonov Daniar, Roller Chris, Ferreti Ludovic, Russo Giogio, Yafi Faysal A, Cuzin Beatrice, Madec François-Xavier, Vanoverschelde Geoffroy, Hervé François, Chung Eric, Nordström Ulla, Cocci Andrea, Zahr Rawad Abou, Triffaux François, Suks Minhas, Alnajjar Hussain, Van Damme Julien, Ward Sam
Department of Urology, Centre Hospitalier Universitaire, Université Catholique de Louvain, 5000 Namur, Belgium.
Department of Urology, Cliniques Universitaires Saint-Luc, 1200 Bruxelles, Belgium.
Sex Med. 2025 Jan 23;12(6):qfae094. doi: 10.1093/sexmed/qfae094. eCollection 2024 Dec.
Vasectomy is a widely used, safe, effective method of permanent contraception and contributes to healthy sexuality.
We have conducted a 3-step observational clinical study to develop a vasectomy regret risk score and guide patients and clinicians when discussing a vasectomy.
A 3-step approach has been followed. First, experts involved in male health have proposed risk factors for regret (remorse) after vasectomy, defined by a vasectomy reversal surgery or medically assisted reproduction. The selected factors were evaluated in 1200 patients vasectomized in the last 15 years. Finally, the expert panel has constructed a score for predicting regret after vasectomy.
Fifty-two international experts identified 17 risk factors for vasectomy regret. Five of the risk factors were significant: an age <35 years old, a high Barrat Impulsivity Score, a low level of education, and a patient who didn't understand that the vasectomy might not be reversible or for whom the contraception responsibility is ideally feminine, or no responsible partner. On multivariate analysis, 3 risk factors and 2 "sine qua non" conditions were used to build the decision algorithm. A risk score ≥ 4 required information on sperm cryopreservation before vasectomy, and those with a risk score ≥ 7 required extra time for reflection. The scoring system was proposed to 52 international experts and accepted with 86.7% strongly agreeing. The model's sensitivity and specificity were 0.98 and 0.53, respectively.
A decisional algorithm was established to identify patients requiring information on sperm cryopreservation before vasectomy or additional time for reflection to reduce the risk of vasectomy regret. The algorithm contains 3 risk factors and 2 "" conditions.
输精管结扎术是一种广泛应用的、安全有效的永久性避孕方法，有助于促进健康的性行为。
我们开展了一项三步观察性临床研究，以制定输精管结扎术后悔风险评分，并在讨论输精管结扎术时为患者和临床医生提供指导。
采用了三步法。首先，男性健康领域的专家提出了输精管结扎术后后悔（懊悔）的风险因素，通过输精管复通手术或医学辅助生殖来定义。在过去15年中接受输精管结扎术的1200名患者中对选定的因素进行了评估。最后，专家小组构建了一个预测输精管结扎术后后悔的评分。
52名国际专家确定了17个输精管结扎术后悔的风险因素。其中5个风险因素具有统计学意义：年龄<35岁、巴拉特冲动评分高、教育程度低、不理解输精管结扎术可能不可逆的患者，或认为避孕责任理想上应由女性承担的患者，或没有责任伴侣的患者。在多变量分析中，使用3个风险因素和2个“必要”条件来构建决策算法。风险评分≥4需要在输精管结扎术前了解精子冷冻保存信息，风险评分≥7的患者需要额外的时间进行思考。该评分系统提交给52名国际专家，86.7%的专家强烈同意。该模型的敏感性和特异性分别为0.98和0.53。
建立了一种决策算法，以识别在输精管结扎术前需要了解精子冷冻保存信息或需要额外时间进行思考的患者，以降低输精管结扎术后悔的风险。该算法包含3个风险因素和2个“必要”条件。
