Scheduling Appointments for Postvasectomy Semen Analysis Has No Impact on Compliance

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 t 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%], p = 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, p = 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.

Providing a post-vasectomy semen analysis cup at the time of vasectomy rather than post-operatively improves compliance

“…Our results join a body of work where numerous approaches have been studied in attempting to increase PVSA completion rates, though none have been proven to show a consistent advantage ( 6 , 8 , 10 , 12 ). Data is equivocal regarding the value of a separate appointment for PVSA completion.…”

“…Data is equivocal regarding the value of a separate appointment for PVSA completion. In a retrospective analysis of 387 vasectomy patients, Jacobsen et al compared PVSA compliance rates with drop-in style appointments 8–16 weeks after vasectomy versus mandated, scheduled PVSA appointments at time of vasectomy and found no significant differences ( 12 ). However, a study by Dhar et al , 2007 investigating a similar comparison found that among 228 men, 65% returned for PVSA without an appointment while those with pre-scheduled PVSA appointment returned 84% of the time ( 13 ).…”