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Compliance with Post Vasectomy Semen Analysis: Comparison of in office fresh testing with scheduled office visit vs. fresh laboratory drop off alone
Katrina Jackson, BS1, Brooke Harnisch, MD
2, Stanton Honig, MD
3, Ankur Choksi, MD
3.
1University of Connecticut, farmington, CT, USA,
2UConn Health, Farmington, CT, USA,
3Yale Medicine, New Haven, CT, USA.
Introduction Post vasectomy semen analysis(PVSA) is a critical component to postoperative care following vasectomy surgery, yet compliance remains low ranging from 28-87% in earlier studies. There are no guidelines on the best form of PVSA, whether completed in office, in a lab or via home testing. The aim of this study was to determine whether fresh office-based microscopy with in-person visit or fresh lab-based test with follow-up provider phone call offered the best PVSA compliance rates in our practice.
Methods A retrospective cohort study was conducted at an academic institution who utilize either office-based microscopy with an in person visit or lab-based tests with no defined follow up visit. Patients were stratified into lab-based test(Surgeon 1) and office-based microscopy(Surgeon 2). Patient compliance was defined as completion of a PVSA and either an in-office or phone call confirming the results by the surgeon. Mann Whitney-U test was utilized for continuous variables and Pearson chi-squared test was used for categorical variables. Comparison of compliance was done using a multivariate logistic regression analysis.
Results 291 vasectomies were reviewed(2018-2024), with Phone call(Surgeon 1) cohort(N=178) and In-Office(Surgeon 2) cohort(N=113). The two groups were similar with regards to age, race, marital status, and length of time between vasectomy and PVSA testing. Mean length of time between vasectomy and PVSA test for Surgeon 1 and 2 was 105.26 and 122.84, respectively (p = 0.64). On univariate and multivariate logistic regression, in-office follow up type had a greater likelihood of compliance as compared to phone call visit(OR 2.64, 95% CI: 1.51-4.63, p-value 0.001).
Conclusion In-office PVSA increases compliance when compared to lab-based testing followed by a telephone visit. Limitations include variation of provider between cohorts and potential differing communication with patients about the necessity of PVSA completion. Further research should be done on mitigating factors of compliance.
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