Review of current practice to establish success after vasectomy

Background: This study aimed to examine the criteria used by surgeons in a district general hospital to confirm success following vasectomy, to establ ish the proportion of men undergoing vasectomy in whom the procedure was un successful according to those criteria, and to evaluate their subsequent ma nagement. Methods: All 15 surgeons performing vasectomy indicated that they required two consecutive azoospermic postvasectomy semen specimens before they advis ed couples that the vasectomy was successful. Results of postvasectomy seme n analysis (PVSA) for all 240 primary vasectomies performed over a 12-month interval were analysed. Minimum follow-up was 30 (range 30-42; median 37) months. Results: At follow-up 72 men (30 per cent) had not returned postvasectomy s amples that fulfilled the criteria, including 18 who were azoospermic on th e first PVSA 3 months after vasectomy but who failed to produce a second sp ecimen. In 24 men (10 per cent) who failed to comply with the PVSA protocol , there was no documentation of any further action being taken. No pregnanc ies were reported in the partners of the study group during this interval a nd only one patient underwent repeat vasectomy. Conclusion: The results suggest that the strict requirement of two consecut ive azoospermic postvasectomy semen specimens may be unjustified, leads to a high level of non-compliance and causes unnecessary delay in confirming s uccess of the procedure.