IS THE TIMING OF POSTVASECTOMY SEMINAL ANALYSIS IMPORTANT

Objective To review the practice in two hospitals with differing proto cols in the timing of seminal analysis after vasectomy, Patients and m ethods The results from 245 vasectomies carried out at Hospital A, whe re semen was assessed 3 months after vasectomy, were reviewed and comp ared with those from 100 consecutive vasectomies at Hospital B, where semen was assessed 6 months after vasectomy, The results of seminal an alysis at Hospital A were also audited after changing to the 6-month p rotocol, The patients' preferences for the timing of seminal analysis were also obtained, Results Of the 245 patients at Hospital A, 58 (24% ) failed to provide samples, leaving 187 (76%) for evaluation; 528 sam ples were examined (mean 2.8 per patient, range 1-13), The first sampl e was positive in 36 (19.3%) and the second positive in 10 (5.3%), the first being negative, Four (2%) patients had persistent spermatozoa a t 6 months, one subsequently undergoing exploration, Thirty-one (17%) patients provided further samples despite providing two consecutive cl ear ones, At Hospital B, 24 (24%) patients failed to provide samples; 10 (13%) patients had persistent spermatozoa at 6 months and live sper matozoa were detected in one patient's samples, All eventually produce d clear samples, with none requiring exploration. After changing the p rotocol, 87 vasectomies were performed, with 18 (21%) patients failing to provide samples; seven (10%) of the samples collected showed occas ional nonmotile spermatozoa at 6 months in either the first, second or both samples, with all samples clear by 8 months after vasectomy. Con clusions The complete disappearance of spermatozoa after vasectomy tak es longer than is generally believed and we therefore suggest that giv en adequate counselling, seminal analysis 6 months after vasectomy is cost-effective and in the patient's interest.