title: Medical professional responsibility for postvasectomy pregnancy.
abstract: BACKGROUND
  The follow-up of patients postvasectomy is frequently limited to a seminogram at 3months if azoospermia is observed. This study evaluates a series of cases of complaints for postvasectomy pregnancy to establish follow-up recommendations that increase the clinical safety and reduce the risk of complaints.
  
  
  METHODS
  We reviewed the database of the Department of Professional Responsibility of the Council of the College of Physicians of Catalonia, finding 28 complaints for postvasectomy pregnancy between 1992 and 2011. We analysed the clinical and legal variables of the cases.
  
  
  RESULTS
  A total of 13 extrajudicial complaints (46.43%), 13 civil lawsuits (46.43%) and 2 criminal lawsuits (7.14%) were recorded. Only 10 cases had a signed document of informed consent specific to vasectomy. In 26 cases, the data from the spermogram was available. A single spermogram was conducted in 20 cases (76.92%), 2 spermograms were conducted in 4 cases (15.38%) and none were performed in 2 cases (7.69%). For 9 of the cases (45%) where only a single spermogram was performed, the test was performed before 3months postvasectomy. In 17 cases (65.38%), the result of the last spermogram was azoospermia, and 3 cases had oligospermia (11.54%). There were 2 failures of interpretation of the spermogram (7.69%) and 2 of normospermia (7.69%). In 2 cases, a spermogram was not performed (7.69%). Pregnancy occurred between 4 and 50 months after the intervention. In 12 cases (42.86%), it was considered that the practitioner was responsible.
  
  
  CONCLUSIONS
  It is recommended that physicians emphasise (during the patient information stage) the possibility of spontaneous recanalisation and to request 2 spermograms, whose result should be azoospermia. Performing the test in the 3months after vasectomy is risky, as is basing the waiting time on the number of ejaculations.
authors.affiliation: Servicio de Responsabilidad Profesional, Área de Praxis, Colegio de Médicos de Barcelona, Consejo de Colegios de Médicos de Cataluña, Barcelona, España; Servicio de Urología, Hospital de Viladecans, Institut Catalá de la Salut, Viladecans, Barcelona, España.
authors.forename: C
authors.initials: C
authors.lastname: Vargas-Blasco
authors.affiliation: Servicio de Responsabilidad Profesional, Área de Praxis, Colegio de Médicos de Barcelona, Consejo de Colegios de Médicos de Cataluña, Barcelona, España; Departamento de Salud Pública, Unidad de Medicina Legal, Universidad de Barcelona, Barcelona, España.
authors.forename: J
authors.initials: J
authors.lastname: Arimany-Manso
authors.affiliation: Servicio de Responsabilidad Profesional, Área de Praxis, Colegio de Médicos de Barcelona, Consejo de Colegios de Médicos de Cataluña, Barcelona, España; Hestia Grup, Barcelona, España; Departamento de Medicina y Ciencias de la Salud, Universitat Internacional de Catalunya, Barcelona, España. Electronic address: elgomezduran@comb.cat.
authors.forename: E L
authors.initials: EL
authors.lastname: Gómez-Durán
authors.affiliation: Servicio de Responsabilidad Profesional, Área de Praxis, Colegio de Médicos de Barcelona, Consejo de Colegios de Médicos de Cataluña, Barcelona, España; Departamento de Medicina y Ciencias de la Salud, Universitat Internacional de Catalunya, Barcelona, España; Instituto de Medicina Legal y Ciencias Forenses de Cataluña, Barcelona, España.
authors.forename: C
authors.initials: C
authors.lastname: Martin Fumadó
authors.affiliation: Servicio de Urología, Hospital de Viladecans, Institut Catalá de la Salut, Viladecans, Barcelona, España.
authors.forename: M
authors.initials: M
authors.lastname: Piqueras-Bartolomé
authors.affiliation: Servicio de Urología, Hospital de Viladecans, Institut Catalá de la Salut, Viladecans, Barcelona, España.
authors.forename: S
authors.initials: S
authors.lastname: Capdevila-Querol
authors.affiliation: Servicio de Urología, Hospital de Viladecans, Institut Catalá de la Salut, Viladecans, Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Laborda-Rodriguez
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D016365:Liability, Legal; D008297:Male; D011247:Pregnancy; D013076:Sperm Count; D013997:Time Factors; D017211:Treatment Failure; D014659:Vasectomy
keywords: Embarazo no deseado; Malpractice; Malpraxis; Negligence; Negligencia; Procedimientos quirúrgicos urológicos; Professional responsibility; Responsabilidad profesional; Undesired pregnancy; Urological surgical procedures; Vasectomy; Vasectomía