Abstract

Text-Size + –

• INTRODUCTION Although the importance of post-vasectomy semen analysis (PVSA) is well known, compliance with this test has historically been low. We sought to compare compliance with PVSA when using a home-based testing kit with traditional office based microscopy, and to estimate the impact of compliance differences on the risk of undetected vasectomy failure.

  MATERIALS AND METHODS:

  A retrospective review of vasectomies performed by three providers was performed. Patients were prescribed either traditional office-based PVSA testing (Group 1) or home-based PVSA testing (Group 2). Compliance with PVSA testing was defined as completion of at least one PVSA test. Decision analysis methodology was applied to estimate the risk of undetected vasectomy failure in each group.

  RESULTS:

  A total of 226 vasectomies were reviewed, 141 in Group 1 and 85 in Group 2. The compliance rate was 65.96% in Group 1 compared to 76.47% in Group 2 (p = .095). When utilizing a single home-based test, the estimated risk of undetected vasectomy failure was 3.65% in Group 1 compared to 4.09% in Group 2. When utilizing two serial home-based tests, the estimated risk in Group 2 decreased to 2.87%.

  CONCLUSION:

  As home-based PVSA tests become more widely available, it is important to understand their impact. The availability of such tests may lead to improved compliance with PVSA testing. In turn, increased compliance may offer increased detection of vasectomy failure. Further study is needed with regard to the impact of home-based tests.