(258) LACK OF PATIENT COMPLIANCE COMPROMISES SAFETY OF VASECTOMY

Abstract Objectives Vasectomy is worldwide considered a cost-effective, definitive and safe method for male contraception and therefore one of the most frequently performed outpatient surgeries. However, repeated spermiogram controls to ascertain azoospermia are generally recommended to guarantee successful operation. This legal necessity, with all its implications, is noted in all signed informed consents basically to avert unjustified medical liability issues. Methods Members of the Austrian Andrological Working Group participate to this nationwide, retrospective data analysis for vasectomy in 2020. The primary aim was to investigate patients adherence/consultations according to the preoperative provided instructions. An anonymous dataset over 610 patients was analyzed. Results The mean patient age of was 41.60 years (SD 6.69), with the youngest male being 25 years old and the oldest male being 68 years old. A documented follow-up appointment for first spermiogram-analysis was scheduled for these patients in 96.89% (n=591), but, only 90.19% (n=533) attended to these appointments by achieving azoospermia in 86.00% (n=436). In 71 cases vital sperm could still be detected in the ejaculate (unknown in 26 cases). A second spermiogram control was scheduled for 87.24% (n=465 patients; unknown in 24 cases) and was attended by 392 patients (84.30% of patients), hereby azoospermia was achieved in 91.33% (n=358; unknown in 2 cases). Complications such as hematoma, edema, or infection were reported in only 25 patients (4.10%). Failure to achieve sperm clearance was age-independent. Conclusions Although being a safe procedure with a low complication rate, post-vasectomy follow-up lacks extensive adherence. Roughly 10% of patients missed the required post-vasectomy controls and this regardless of the informed consent signed by the patient. Due to persisting oligozoospermia in 14% of patients after the first and 9% after the second follow-up visit, patients must be encouraged to attend the previously scheduled follow-up appointments. To guarantee a successful operation and safe contraception follow-up visits are crucial. Conflicts of Interest None