Objective: To determine the postoperative instruction compliance rate in men undergoing bilateral vasectomy.
Design: Retrospective chart review.
Setting: Private practice urological office.
Patient(s): The records of all patients undergoing vasectomy were reviewed to determine the rate of compliance with postvasectomy follow-up instructions. It is our policy to have the patient continue to use some form of birth control until he achieves two consecutive negative semen analyses 1 month apart. In addition, we recommend a yearly semen analysis after achieving sterility to screen for the rare patient who recanalizes. Postvasectomy follow-up instructions are given to the patient both verbally and in writing.
Intervention(s): None.
Main outcome measure(s): The records of 1,892 consecutive patients undergoing vasectomy were reviewed, and the results of semen analyses were noted to determine the rate of compliance with postvasectomy follow-up instructions.
Result(s): Six hundred forty-four men (34%) never returned after vasectomy and, therefore, no semen analyses were available for examination. Six hundred nineteen men (33%) returned for a single semen analysis. Six hundred twenty-nine men (33%) returned for a second negative semen analysis. Only 60 men (3%) completed postvasectomy follow-up instructions and returned for a yearly semen analysis.
Conclusion(s): The rate of compliance with postvasectomy follow-up instructions for determining sterility is poor.
PIP: To determine the rate of patient compliance with post-vasectomy instructions for verifying sterility, the records of all 1892 men undergoing bilateral vasectomy in a private urological practice in Grand Rapids, Michigan, during 1985-95 were reviewed. Vasectomy acceptors at this practice are instructed to use some form of birth control until 2 consecutive negative semen analyses 1 month apart have been recorded. In addition, a yearly semen analysis is recommended to screen for recanalization. These post-vasectomy instructions are delivered verbally on 1 occasion and 3 times in writing. 644 men (34%) never returned after vasectomy. Another 619 men (33%) returned only for a single semen analysis, even though 36 had a positive test result. 629 men (33%) with an initial negative result returned for a second semen analysis; in 65 cases, the second analysis failed to document azoospermia. A total of 157 men with positive first or second semen analyses never were cleared. Only 60 men (3%) returned for the yearly semen analysis. 8 pregnancies (0.4%) were reported in this series, all of which involved men who had not followed the post-vasectomy protocol. These findings underscore the need for thorough patient education on the importance of the post-vasectomy follow-up.