ABSTRACT
OBJECTIVES: To establish an adequate follow-up protocol based on time to azoospermia achievement after vasectomy. Also, to review the rate of complications in our setting. METHODS: Retrospective analysis of 391 men who underwent vasectomy. Follow-up was performed by means of semen analysis 6 months after surgery, and then every 3 months until azoospermia was achieved. Data of visits to the emergency unit at our centre were obtained within the first 30 postoperative days. RESULTS: During follow-up 567 semen analysis were performed. From 391 vasectomy interventions, 275 had at least one semen sample available and valid for processing. After the first 6 months from surgery, 41.1%men still presented nonmotile rare sperm in semen analysis, 9.7% after 9 months, and 4.7% after 12 months. If semen analysis was postponed from 6 to 9 months after surgery, a total yearly saving of 6,153.23 Euro would be observed in our setting, but with the drawback of delaying the diagnosis of azoospermia in nearly 60% of men. Overall complication rate was 3.1%(only one man required hospital admittance and reintervention). No statistical difference was observed in operative time with regard to the presence or absence of urological complications. CONCLUSIONS: The percentage of men not achieving azoospermia 6 months after surgery is notorious. Vasectomy practice in our setting seems to be reliable and safe, with a limited rate of complications.
Subject(s)
Vasectomy , Adult , Follow-Up Studies , Humans , Male , Middle Aged , Retrospective Studies , Semen Analysis , Spain , Treatment Failure , Urban Health , Vasectomy/adverse effectsABSTRACT
OBJECTIVES: To establish an adequate follow-up protocol based on time to azoospermia achievement after vasectomy. Also, to review the rate of complications in our setting.METHODS: Retrospective analysis of 391 men who underwent vasectomy. Follow-up was performed by means of semen analysis 6 months after surgery, and then every 3 months until azoospermia was achieved. Data of visits to the emergency unit at our centre were obtained within the first 30 postoperative days.RESULTS: During follow-up 567 semen analysis were performed. From 391 vasectomy interventions, 275 had at least one semen sample available and valid for processing. After the first 6 months from surgery, 41.1% men still presented nonmotile rare sperm in semen analysis, 9.7% after 9 months, and 4.7% after 12 months. If semen analysis was postponed from 6 to 9 months after surgery, a total yearly saving of 6,153.23 Euro would be observed in our setting, but with the drawback of delaying the diagnosis of azoospermia in nearly 60% of men. Overall complication rate was 3.1% (only one man required hospital admittance and re-intervention). No statistical difference was observed in operative time with regard to the presence or absence of urological complications.CONCLUSIONS: The percentage of men not achieving azoospermia 6 months after surgery is notorious. Vasectomy practice in our setting seems to be reliable and safe, with a limited rate of complications(AU)
OBJETIVO: Establecer un protocolo de seguimiento adecuado basado en el tiempo necesario para conseguir la azoospermia tras la realización de vasectomía, y revisar la frecuencia de complicaciones en nuestro entorno.MÉTODOS: Análisis retrospectivo de 391 vasectomías. Seguimiento mediante seminograma postvasectomía a los 6 meses de la intervención, y posteriormente con periodicidad trimestral hasta conseguir la azoospermia. Registro de las frecuentaciones en el Servicio de Urgencia de nuestro centro dentro de los 30 días del postoperatorio.RESULTADOS: Durante el seguimiento se han llevado a cabo 567 seminogramas. De las 391 vasectomías realizadas, 275 presentaron al menos una muestra válida para su procesamiento. Al finalizar los 6 meses tras la cirugía un 41,1% presentaron espermatozoides aislados inmóviles en el seminograma, 9,7% tras los 9 meses, y 4,7% al finalizar los 12 meses. El retrasar el primer seminograma de los 6 a los 9 meses tras la intervención supondría un ahorro de 6153,23 Euros anuales en nuestro entorno, con la desventaja de diferir el alta de casi el 60% de los pacientes intervenidos. La tasa de complicaciones se situó en el 3,1% (sólo un paciente requirió reintervención e ingreso). No existió diferencia significativa en cuanto al tiempo operatorio en los pacientes con o sin complicación urológica.CONCLUSIONES: La proporción de pacientes que no alcanzan la azoospermia tras los 6 meses postcirugía es notable. La práctica de la vasectomía parece fiable y relativamente segura en nuestro entorno, con una contenida tasa de complicaciones
