The high rate of noncompliance for post-vasectomy semen examination: medical and legal considerations.
The records of 1,029 consecutive patients undergoing bilateral vasectomy were reviewed. Of the 1,029 patients 375 (36%) never returned postoperatively and the partners of 2 of these 375 later became pregnant. A total of 560 patients (54%) was followed until the recommended demonstration of azoospermia occurred on 2 consecutive occasions. There were 84 patients (8%) who did not return after the first demonstration of azoospermia, while 7 (1%) still had sperm in the semen at the last examination. Three other patients had persistent nonmotile sperm postoperatively; 2 of them underwent repeat vasectomy followed by azoospermia and 1 was placed in a special clearance category of sterility as described. We discuss practical and legal considerations regarding the management of noncompliant patients.
Belker
A M
AM
Department of Surgery (Division of Urology), University of Louisville School of Medicine, KY.
Sexter
M S
MS
Sweitzer
S J
SJ
Raff
M J
MJ
D005260:Female; D013502:General Surgery / Q000331:legislation & jurisprudence*; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence; D007629:Kentucky; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence; D010334:Paternity; D010349:Patient Compliance; D011247:Pregnancy; D011275:Pregnancy, Unwanted; D012661:Semen / Q000032:analysis*; D013223:Statistics as Topic; D014659:Vasectomy