After a man has a vasectomy, the American Urological Association recommends that he later completes a semen analysis to confirm the procedure was successful. The percentage of patients that do so, however, is unclear. Current research states anywhere from 28% to about half of men adhere to these guidelines, suggesting there are barriers to adherence.
Though traditionally performed in a clinic or lab setting, mail-in testing kits may offer patients more flexibility and convenience. Researchers from the University of Missouri School of Medicine examined the adherence rate between patients who came to the clinic for analysis versus those who mailed in a sample and found no significant difference in adherence rates.
“During the COVID-19 pandemic, the urology clinic transitioned to mail-in testing kits to reduce foot traffic,” co-author Mark Doss said. “This is a point of controversy in the urological community, as traditional lab testing requires a fresh sample to be analyzed within two hours. Mail-in kits won’t have fresh samples and require a different kind of analysis. Both methods are similarly accurate in determining if a vasectomy was successful.”
The team examined de-identified data of 966 patients between January 2015 and September 2023. All patients after February 2020 mailed in samples, a total of 374 people. The adherence rate did not significantly differ, which supports the institutional clinical decision to continue offering mail-in options after pandemic measures lifted.
“In general, our institution’s rate of adherence is high compared to the published literature – about 80-85%,” co-author Mark Wakefield said. “We also found that mail-in testing was significantly more likely to complete a post-vasectomy analysis within 6 months, so it made sense to keep it as an option for patients.”
Although the team didn’t find a significant difference in completion rates for patients traveling more than one hour, this still presents an opportunity to make follow-up vasectomy care more accessible to rural areas.
“Instead of having to schedule time for a long drive, patients can complete post-vasectomy analyses in their homes,” Doss said. “Our findings may be limited since we conducted the study in an area with already high compliance, but we believe mail-based options are safe, feasible, and can help improve low rates of completion in other regions.”
Mark Doss is a fourth-year medical student at the Mizzou School of Medicine. Mark R. Wakefield, MD, is a professor of surgery and Division Chief of Urology at the Mizzou School of Medicine, and a urologist at MU Health Care.
“Post Vasectomy Semen Analysis Completion in Clinic-Based Versus Mail-In Testing” was recently published in the journal Urology. In addition to Doss and Wakefield, Mizzou study authors include urology residents Hunter Kraus, MD and Glendon Markollari, MD; Shelby Salisbury, medical student; Chase Schlesselman, research data analyst with MUSCORE, a team of data analysts with the Department of Surgery; and Eliza DeFroda, MD, urologist and assistant professor of urologic surgery.
