title: Reduced Postvasectomy Semen Analysis Testing With the Implementation of Special Clearance Parameters.
abstract: OBJECTIVE
  To determine the applicability of postvasectomy special clearance parameters (<100,000 nonmotile sperm/mL on semen analysis) suggested by the American Urological Association and to define the associated cost savings with avoidance of further testing.
  
  
  METHODS
  We retrospectively reviewed the cohort of men undergoing vasectomy from December 2009 to August 2012 at a single institution. Patient demographics and postvasectomy semen analysis (PVSA) results were collected for clearance parameter comparisons.
  
  
  RESULTS
  During the study period, 230 patients underwent vasectomy with a mean ± SD age of 36.4 ± 6.5 years. Among the cohort, 83.5% were married and 95.2% had one or more children. The initial PVSA was completed by 111 (48.3%) patients at a mean of 17.8 weeks (range 4-45) following vasectomy. Sperm was identified on initial PVSA in 40 patients (36.0%); 1 patient was found to have motile sperm. Of 39 patients, 38 (97.4%) with nonmotile sperm on PVSA could be cleared to cease other contraceptives based on the most recent clearance guidelines. For those completing an initial PVSA, postvasectomy clearance increased from 64.0% to 98.2% representing a potential cost savings of $2356 in repeat semen testing.
  
  
  CONCLUSIONS
  Postvasectomy contraceptive clearance can be greatly increased when rare nonmotile sperm parameters are included although postvasectomy semen testing compliance remains poor.
authors.affiliation: Department of Urology, Geisinger Medical Center, Danville, PA. Electronic address: jbieniek@mtsinai.on.ca.
authors.forename: Jared M
authors.initials: JM
authors.lastname: Bieniek
authors.affiliation: Department of Internal Medicine, University of Kentucky, Lexington, KY.
authors.forename: Tyler B
authors.initials: TB
authors.lastname: Fleming
authors.affiliation: Department of Urology, Geisinger Medical Center, Danville, PA.
authors.forename: Joseph Y
authors.initials: JY
authors.lastname: Clark
mesh_terms: D000328:Adult; D053713:Azoospermia / Q000175:diagnosis*; D017046:Cost Savings; D006801:Humans; D008297:Male; D020380:Needs Assessment; D010349:Patient Compliance; D012189:Retrospective Studies; D055101:Semen Analysis / Q000191:economics / Q000379:methods / Q000523:psychology; D014659:Vasectomy