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- Title
(385) Compliance with Post-Vasectomy Semen Analysis (PVSA): A Retrospective Survey Study.
- Authors
Goodstein, T; Shreram, U; Posid, T; Lombardo, A; Asif, H; Sweigert, S; Delancey, J; Springer, E; Riedinger, E; Yih, J
- Abstract
Introduction: After undergoing vasectomy, sterility must be confirmed with PVSA obtained ~12 weeks and at least 20 ejaculations after the procedure. Sterility is defined as azoospermia or rare non-motile sperm (<100,000 non-motile sperm/mL). In the literature, compliance for obtaining PVSA has been reported at ~53%. Prior retrospective research has demonstrated that the compliance rate for PVSA at our institution is considerably higher than this, at 89%, which may relate to practice patterns that improve follow-up. Noncompliance has been linked to a number of patient circumstances, though limited studies have explored this from the patient's perspective. Objective: To identify patient-related factors associated with PVSA compliance and describe perceived barriers for not obtaining PVSA. Methods: An anonymous survey was sent via REDCap to patients who underwent vasectomy at our institution from February 2020 to February 2023 (n = 134, 14.4 RR; 7.3% in 2020, 31.8% in 2021, 60.9% in 2022). Participants provided demographics, answered questions about their vasectomy, and reported reasons for completing or failing to complete PVSA (IRB 2022H0457). Results: Study Sample: Patients were 98.4% cis male, 88.7% heterosexual, and 93.2% white, with a mean age of 37.9 years (SD = 6.05 yrs). The majority of patients held a Bachelor's degree or higher (79.6%) and the mean reported annual income was $100,000–150,000. Eighty-two percent of patients were married; the majority had been married for more than 5 years (85.3%). Seventy-four percent had at least one child. Fifty-one percent said insurance covered the procedure completely while 48% said insurance covered the procedure partially. Survey Results: Patients rated their vasectomy procedure pain at 4.3/10 (SD = 2.6) and their post-vasectomy pain at 3.6/10 (SD = 2.03). Patients reported an average out-of-pocket cost for their vasectomy of $439.57 (SD = $358.66). Ninety-nine percent of patients said they had completed their PVSA and 16.2% reported that there was an out-of-pocket cost for their SA. PVSA Compliance Factors: 97.5% of patients were told about the need to verify their sterility at their initial consultation, 97.5% were told this again on their procedure day, 99.2% were given clear PVSA instructions, 92.4% had their lab appointment pre-scheduled, 89.9% were given a semen cup, and 80.7% received an appointment reminder for their SA. Ninety-five percent of patients were sterile on their first SA; of the 5.1% who were not, all but one had already completed a second SA. We asked men what made them most likely to comply with getting a PVSA. The most popular answer was being provided with an appointment reminder, followed by lab proximity to home. Conclusions: Our institution has an impressively high PVSA compliance, possibly because of several workflow interventions, including appointment reminders, pre-scheduling of PVSA, and repetitive provider-facilitated engagement about PVSA necessity. Lab-home proximity is specifically important to patients, likely because it allows for them to obtain specimen at home. These results may provide a model for other institutions and centers hoping to increase their PVSA compliance. Disclosure: No.
- Subjects
VASECTOMY; SEMEN analysis; PATIENTS' attitudes; BACHELOR'S degree; MALE infertility; AZOOSPERMIA
- Publication
Journal of Sexual Medicine, 2024, p1
- ISSN
1743-6095
- Publication type
Article
- DOI
10.1093/jsxmed/qdae001.370