The Jourrnal of Urology / American Urological Association
April 2011
By: Ethan Grober, Eyun-Jung Shin
INTRODUCTION AND OBJECTIVES
Many surgeons assume that patients who don't return for follow-up after surgery are happy with their outcomes. The goal of the current study was to contact and analyze the outcomes of patients 'lost to follow-up' following vasectomy reversal (VR).
Many surgeons assume that patients who don't return for follow-up after surgery are happy with their outcomes. The goal of the current study was to contact and analyze the outcomes of patients 'lost to follow-up' following vasectomy reversal (VR).
METHODS
All patients who underwent vasectomy reversal by a single surgeon from 2007 to 2010 were analyzed and categorized as to their follow-up status. The follow-up protocol after VR included an office, telephone or email evaluation 4 weeks following surgery with semen analysis performed at 3-month intervals until pregnancy is achieved. Patients with no follow-up within 6 months after VR were considered lost to follow-up and contacted by telephone to review their outcomes following surgery and better appreciate the circumstances for lack of post-operative evaluation.
All patients who underwent vasectomy reversal by a single surgeon from 2007 to 2010 were analyzed and categorized as to their follow-up status. The follow-up protocol after VR included an office, telephone or email evaluation 4 weeks following surgery with semen analysis performed at 3-month intervals until pregnancy is achieved. Patients with no follow-up within 6 months after VR were considered lost to follow-up and contacted by telephone to review their outcomes following surgery and better appreciate the circumstances for lack of post-operative evaluation.
RESULTS
Of 217 consecutive VRs, 155 (71%) patients were at least 6 months from their VR surgery date. Of these men 116 (75%) complied to some degree with follow-up and their semen analysis, patency or pregnancy status was known. In this population the patency and pregnancy were rates were 96% and 42%, respectively. 39 patients had no documented post VR follow-up. Among them, 12 (31%) had achieved pregnancy, 5 (13%) had performed a semen analysis that was not made available to our centre, 12 (31%) were planning on performing a semen analysis in the future, 2 (5%) were no longer interested in conception and 8 men (20%) remained lost to follow-up.
Of 217 consecutive VRs, 155 (71%) patients were at least 6 months from their VR surgery date. Of these men 116 (75%) complied to some degree with follow-up and their semen analysis, patency or pregnancy status was known. In this population the patency and pregnancy were rates were 96% and 42%, respectively. 39 patients had no documented post VR follow-up. Among them, 12 (31%) had achieved pregnancy, 5 (13%) had performed a semen analysis that was not made available to our centre, 12 (31%) were planning on performing a semen analysis in the future, 2 (5%) were no longer interested in conception and 8 men (20%) remained lost to follow-up.
CONCLUSIONS
Truly accurate outcome determinations following VR (and other surgical treatments) require evaluation and follow-up of all patients. Our results suggest that the outcomes of patients lost to follow-up may not match those of patients who return for post-operative evaluation. Surgeons may not be able to rely on the notion that patients who are “lost to follow-up” are satisfied with their surgical outcomes.
Truly accurate outcome determinations following VR (and other surgical treatments) require evaluation and follow-up of all patients. Our results suggest that the outcomes of patients lost to follow-up may not match those of patients who return for post-operative evaluation. Surgeons may not be able to rely on the notion that patients who are “lost to follow-up” are satisfied with their surgical outcomes.