Patient noncompliance with postvasectomy semen examination protocol.

This study determined the degree of patient compliance with postvasectomy semen examination protocol for verbal instructions as compared with verbal augmented by written instructions. The addition of written instructions did not improve patient compliance, and for a significant majority of patients (68 to 76 percent) there was no laboratory verification of the effectiveness of the vasectomy procedure. Results of the study raise serious concerns about physician reliance on patient compliance for postvasectomy semen examination protocol as assurance of successful vasectomy. When the potential for fertility among vasectomized men is uncertain, the complication of an unwanted pregnancy will fall on the woman. Educating physicians in the problems and strategies for gaining patient compliance is as essential as education in competent surgical technique.