178 Low Adherence to Post-Vasectomy Semen Analysis in the VA Population

Abstract

Post-vasectomy semen analysis (PVSA) is required to confirm the success of vasectomy procedure per established guidelines. We sought to determine the performance of PVSA as well as factors that influenced adherence in veterans who underwent vasectomy over a 10-year period. A retrospective review of men who underwent vasectomy at our Veterans Administration Medical Center between January 2006 and May 2016 was performed. All patients had pre-procedure consultation and counselling at least once. Counselling included emphasis that PVSA was required for definitive confirmation of the procedure's success and other contraceptive methods should be used prior to negative PVSA. Vasectomies were performed under local anesthesia in the outpatient clinic setting or under general anesthesia in the operating room. All specimens were sent for pathologic confirmation of presence or absence of vas with lumen. Post-vasectomy management included follow-up in in 2-4 weeks for wound check with semen analysis performed within 1-3 months after 15-20 post-procedural ejaculations. Standard statistical analysis was performed to assess for factors that predicted adherence to PVSA.