Post-vasectomy semen analysis: Optimizing laboratory procedures and test interpretation through a clinical audit and global survey of practices
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info:eu-repo/semantics/openAccessAttribution-NonCommercial 4.0 Internationalhttps://creativecommons.org/licenses/by-nc/4.0/Tarih
2022Yazar
Agarwal, AshokGupta, Sajal
Sharma, Rakesh K.
Finelli, Renata
Kuroda, Shinnosuke
Vij, Sarah C.
Boitrelle, Florence
Kavoussi, Parviz
Rambhatla, Amarnath
Saleh, Ramadan
Chung, Eric
Mostafa, Taymour
Zini, Armand
Ko, Edmund
Parekh, Neel
Martinez, Marlon
Arafa, Mohamed
Tadros, Nicholas
Rosette, Jean de la
Le, Tan V.
Rajmil, Osvaldo
Kandil, Hussein
Blecher, Gideon
Liguor, Giovanni
Caroppo, Ettore
Ho, Christopher C.K.
Altman, Andrew
Bajic, Petar
Goldfarb, David
Gill, Bradley
Zylbersztejn, Daniel Suslik
Molina, Juan Manuel Corral
Gava, Marcello M.
Cardoso, Joao Paulo Greco
Kosgi, Raghavender
Çeker, Gökhan
Zilaitiene, Birute
Pescatori, Edoardo
Borges Jr, Edson
Duarsa, Gede Wirya Kusuma
Pinggera, Germar-Michael
Busetto, Gian Maria
Balercia, Giancarlo
Franco, Giorgio
Çalik, Gökhan
Sallam, Hassan N.
Park, Hyun Jun
Ramsay, Jonathan
Alvarez, Juan
Khalafalla, Kareim
Bowa, Kasonde
Hakim, Lukman
Simopoulou, Mara
Rodriguez, Marcelo Gabriel
Sabbaghian, Marjan
Elbardisi, Haitham
Timpano, Massimiliano
Altan, Mesut
Elkhouly, Mohamed
Al-Marhoon, Mohamed S.
Gilani, Mohammad Ali Sadighi
Soebadi, Mohammad Ayodhia
Nasr-Esfahani, Mohammad Hossein
Garrido, Nicolas
Vogiatzi, Paraskevi
Birowo, Ponco
Patel, Premal
Javed, Qaisar
Ambar, Rafael F.
Adriansjah, Ricky
AlSaid, Sami
Micic, Sava
Lewis, Sheena E.
Mutambirwa, Shingai
Fukuhara, Shinichiro
Parekattil, Sijo
Ahn, Sun Tae
Jinda, Sunil
Takeshima, Teppei
Puigvert, Ana
Amano, Toshiyasu
Barrett, Trenton
Toprak, Tuncay
Malhotra, Vineet
Atmoko, Widi
Yumura, Yasushi
Morimoto, Yoshiharu
Lima, Thiago Fernandes Negris
Kunz, Yannic
Kato, Yuki
Umemoto, Yukihiro
Colpi, Giovanni M.
Durairajanayagam, Damayanthi
Shah, Rupin
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Agarwal, A., Gupta, S., Sharma, R. K., Finelli, R., Kuroda, S., Vij, S. C. ... Shah, R. (2022). Post-vasectomy semen analysis: Optimizing laboratory procedures and test interpretation through a clinical audit and global survey of practices. The World Journal of Men's Health, 40. https://dx.doi.org/10.5534/wjmh.210191Özet
Purpose: The success of vasectomy is determined by the outcome of a post-vasectomy semen analysis (PVSA). This article describes a step-by-step procedure to perform PVSA accurately, report data from patients who underwent post vasectomy semen analysis between 2015 and 2021 experience, along with results from an international online survey on clinical practice. Materials and Methods: We present a detailed step-by-step protocol for performing and interpretating PVSA testing, along with recommendations for proficiency testing, competency assessment for performing PVSA, and clinical and laboratory scenarios. Moreover, we conducted an analysis of 1,114 PVSA performed at the Cleveland Clinic’s Andrology Laboratory and an online survey to understand clinician responses to the PVSA results in various countries. Results: Results from our clinical experience showed that 92.1% of patients passed PVSA, with 7.9% being further tested. A total of 78 experts from 19 countries participated in the survey, and the majority reported to use time from vasectomy rather than the number of ejaculations as criterion to request PVSA. A high percentage of responders reported permitting unprotected intercourse only if PVSA samples show azoospermia while, in the presence of few non-motile sperm, the majority of responders suggested using alternative contraception, followed by another PVSA. In the presence of motile sperm, the majority of participants asked for further PVSA testing. Repeat vasectomy was mainly recommended if motile sperm were observed after multiple PVSA’s. A large percentage reported to recommend a second PVSA due to the possibility of legal actions. Conclusions: Our results highlighted varying clinical practices around the globe, with controversy over the significance of non-motile sperm in the PVSA sample. Our data suggest that less stringent AUA guidelines would help improve test compliance. A large longitudinal multi-center study would clarify various doubts related to timing and interpretation of PVSA and would also help us to understand, and perhaps predict, recanalization and the potential for future failure of a vasectomy.
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World Journal of Men's HealthCilt
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