UPJ INSIGHT No Detectable Association Between Virtual Setting for Vasectomy Consultation and Completion Rate

By: Hunter Hernandez, BA, NYU Grossman School of Medicine, New York, New York; Ari P. Bernstein, MD, NYU Grossman School of Medicine, New York, New York; Ethan Zhu, BA, NYU Grossman School of Medicine, New York, New York; Bryce Saba, BA, NYU Grossman School of Medicine, New York, New York; Eli Rapoport, MD, NYU Grossman School of Medicine, New York, New York; Bobby B. Najari, MD, NYU Grossman School of Medicine, New York, New York | Posted on: 19 Jan 2024

Hernandez H, Bernstein AP, Zhu E, Saba B, Rapoport E, Najari BB. No detectable association between virtual setting for vasectomy consultation and vasectomy completion rate. Urol Pract. 2024;11(1):71-76.

Study Need and Importance

As a result of the COVID pandemic, telehealth has become more prevalent in the field of urology. The utility of telehealth for preoperative surgical consultations, and more specifically for vasectomies, is uncertain given the perceived value of physical examination prior to surgical intervention. This study aimed to evaluate whether vasectomy completion rates differed between patients who underwent in-person consultation and those who underwent virtual consultation.

What We Found

We compared 2 groups of patients seen for vasectomy consultation (in person vs virtual) and compared the rates of vasectomy completion among these groups. The first group received in-person consultations (n = 294), while the second group received virtual consultations (n = 197). We found no difference in vasectomy completion rates between those seen in person vs virtually (75.2% vs 75.6%, P = .91). Of the 197 patients who received virtual consultations, only 2 had their vasectomies cancelled on the day of the procedure due to physical exam findings. In terms of patient characteristics, no statistically significant differences were found between those who had in-person consultations and those who had virtual consultations for the following measures: patient age, age of patient’s partner, patient BMI, having children, and history of prior genitourinary infection(s) (Table).

Table. Patient Characteristics Stratified by Vasectomy Preoperative Consultation Setting

	In-person consultation (n = 294)		Remote consultation (n = 197)		P value
Patient characteristic, No. (%)^a
Has children	257	88.9	166	85.1	.22
Prior GU infection	32	11.3	22	11.2	.98
Patient characteristic, median (IQR)^b
Age, y	41.7	7.3	40.3	7.5	.08
Partner’s age, y	39	6	39	6.8	.86
BMI, kg/m²	26.1	5.2	25.8	5.3	.42
Abbreviations: BMI, body mass index; GU, genitourinary; IQR, interquartile range. Missing data: 7 with unknown number of children, 12 with unknown GU infection history, 48 with unknown age of partner. ^aP values derived from chi-square tests. ^bP values derived from Wilcoxon rank-sum testing.

Limitations

A major limitation is the retrospective nature of the study, making it impossible to determine causative effects between consultation setting and procedure cancellation. Additionally, the study cohort consisted entirely of patients seen by a single high-volume provider from a single urban patient population, limiting generalizability.

Interpretation for Patient Care

This study supports the role of telehealth for vasectomy consultation, as it shows no difference in completion rates between in-person and virtual consultation. Day-of-vasectomy cancellations due to concerning physical exam findings are exceedingly rare in patients seen virtually for consultation.