Post-vasectomy semen analysis: Follow-up of patients at three Cape Town Metropole facilities.

Thesis / Dissertation


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Background: Vasectomies are generally considered an underutilised method of contraception worldwide. Our study was aimed at determining patient adherence to the post-vasectomy follow-up plans and whether the procedures were done successfully by the different categories of surgeons at three facilities in the Cape Town Metropole. Methods: We conducted a retrospective chart review of patient folders at three study sites. The sites included were Wesfleur Hospital, Heideveld CDC and Mitchell's Plain CHC. The sociodemographic data and procedure information were extracted from theatre records and patient folders. We retrieved the results of the post-vasectomy semen analysis (PVSA) from the Reproductive Medicine Unit at Groote Schuur Hospital. Results: Our study population included 270 patients who had vasectomies from September 2016 to July 2021. Only 122 (45.2%) PVSA results from those patients that adhered to the follow-up protocol were retrievable, of which 115 (94.2%) showed that the procedure was successfully done. This is below the global estimated success rate of 99%. Conclusion: Missing data from the patient records influenced the results significantly. It was thus not possible to achieve our study objectives fully. A data collection instrument was developed and standardised stationery, already in use at some of the sites, was implemented to provide more complete datasets for future audits. Contribution: The study identified flaws in record-keeping practices at the three study sites. The implementation of the stationery and the data collection instrument may assist future research and quality improvement projects, by tracking procedural success and patient adherence to post-vasectomy semen analyses.