Vasectomy: can the standards be achieved within a primary care setting?

Abstract

BackgroundVasectomy intends to provide permanent contraception by interrupting the vas deferentia via one of several methods. The no-scalpel vasectomy aims to render male sterilisation more acceptable to patients. It is faster and associated with fewer complications. Complications are uncommon, but do exist, most often pain, bleeding, bruising, and infection. Vasectomy is increasingly carried out within a primary care setting. One GP at Marple Cottage Surgery has been performing vasectomies for 5 years.AimThis study aims to ascertain whether vasectomy standards can be achieved within a primary care setting.MethodElectronic patient records and semen analysis data were accessed for procedures performed between April 2013–April 2018, to calculate the failure and complication rates. This was compared to guidelines from relevant advisory bodies.ResultsIn total 910 vasectomies were performed over the period: 5.3% were associated with a complication; 2.0% intraoperative bleeding, 1.5% pain, 0.8% haematoma, 0.7% syncope, and 0.2% infection. Two-thirds (67.3%) of patients provided a semen sample for analysis. The occlusive failure rate was 0.4% and the contraceptive failure rate is 0%.ConclusionComplication rates were low, achieving or exceeding the standards in all domains. The occlusive failure rate is within the <1% American Urological Association acceptable standard and the current contraceptive failure rate is 0%. This is for further analysis with a larger sample size. We are confident that the high standard of vasectomy care can be achieved as the service migrates into primary care.