OBJECTIVE: To prospectively determine the impact of scheduled follow-up appointments with compliance rates after vasectomy. PATIENT AND METHODS: During a study period of 18 months, 228 consecutive men had a vasectomy, of whom 114 were instructed to bring a semen sample to the office and 114 were given a follow-up appointment to submit samples. All men were instructed to submit specimens at 2 months after vasectomy and at 1-month intervals until two consecutive samples were azoospermic. The mean (range) follow-up was 16 (6-24) months. Compliance rates for the appointment and no-appointment group were compared using a two-sided Fisher's exact test. A subgroup analysis used a logistic regression model. RESULTS: In the appointment group, 96/114 (84%) of patients complied with instructions to bring the first sample at 2 months, and in the no-appointment group, 74/114 (65%) complied (P=0.001). In the appointment group, 43/114 (48%) of patients complied with instructions to provide two consecutive azoospermic specimens and in the no-appointment group, 23/114 (20%) complied (P=0.005). A subgroup analysis of patients who provided a sample at 2 months indicated that, on adjusting for the results of the first test, patients with appointments were 1.17 times more likely to provide additional specimens than patients with no appointments. Adjusting for the type of appointment, patients who had sperm present in the first test were 6.72 times more likely to provide additional specimens than patients who were azoospermic on the first test. CONCLUSION: Scheduling an appointment after vasectomy provides a statistically and clinically significant improvement in compliance.
OBJECTIVE: To prospectively determine the impact of scheduled follow-up appointments with compliance rates after vasectomy. PATIENT AND METHODS: During a study period of 18 months, 228 consecutive men had a vasectomy, of whom 114 were instructed to bring a semen sample to the office and 114 were given a follow-up appointment to submit samples. All men were instructed to submit specimens at 2 months after vasectomy and at 1-month intervals until two consecutive samples were azoospermic. The mean (range) follow-up was 16 (6-24) months. Compliance rates for the appointment and no-appointment group were compared using a two-sided Fisher's exact test. A subgroup analysis used a logistic regression model. RESULTS: In the appointment group, 96/114 (84%) of patients complied with instructions to bring the first sample at 2 months, and in the no-appointment group, 74/114 (65%) complied (P=0.001). In the appointment group, 43/114 (48%) of patients complied with instructions to provide two consecutive azoospermic specimens and in the no-appointment group, 23/114 (20%) complied (P=0.005). A subgroup analysis of patients who provided a sample at 2 months indicated that, on adjusting for the results of the first test, patients with appointments were 1.17 times more likely to provide additional specimens than patients with no appointments. Adjusting for the type of appointment, patients who had sperm present in the first test were 6.72 times more likely to provide additional specimens than patients who were azoospermic on the first test. CONCLUSION: Scheduling an appointment after vasectomy provides a statistically and clinically significant improvement in compliance.
Authors: Robert M Coward; Niraj G Badhiwala; Jason R Kovac; Ryan P Smith; Dolores J Lamb; Larry I Lipshultz Journal: J Urol Date: 2013-08-02 Impact factor: 7.450