Amandine Degraeve, Lorenzo Tosco, Bertrand Tombal, Thierry Roumeguere, Jeanne Beirnaert, Robin Hamal, Céline Bugli, Marco Cosentino, Lee Wai Gin Don, Marta Skrodzka, Maarten Albersen, Koenraad van Renterghem, Maxime Sempels, David Penning, Mikkel Fode, Antoine Faix, Marjan Waterloos, Borja Garcia Gomez, Damien Carnicelli, Jean-Pierre Graziana, Afonso Morgado, Kathleen D'Hauwers, Ege Serefoglu, Celeste Manfredi, Emmanuel Weyne, Jack Beck, Daniar Osmonov, Chris Roller, Ludovic Ferreti, Giogio Russo, Faysal A Yafi, Beatrice Cuzin, François-Xavier Madec, Geoffroy Vanoverschelde, François Hervé, Eric Chung, Ulla Nordström, Andrea Cocci, Rawad Abou Zahr, François Triffaux, Minhas Suks, Hussain Alnajjar, Julien Van Damme, Sam Ward
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引用次数: 0
Abstract
Introduction: Vasectomy is a widely used, safe, effective method of permanent contraception and contributes to healthy sexuality.
Aims: We have conducted a 3-step observational clinical study to develop a vasectomy regret risk score and guide patients and clinicians when discussing a vasectomy.
Methods: A 3-step approach has been followed. First, experts involved in male health have proposed risk factors for regret (remorse) after vasectomy, defined by a vasectomy reversal surgery or medically assisted reproduction. The selected factors were evaluated in 1200 patients vasectomized in the last 15 years. Finally, the expert panel has constructed a score for predicting regret after vasectomy.
Results: Fifty-two international experts identified 17 risk factors for vasectomy regret. Five of the risk factors were significant: an age <35 years old, a high Barrat Impulsivity Score, a low level of education, and a patient who didn't understand that the vasectomy might not be reversible or for whom the contraception responsibility is ideally feminine, or no responsible partner. On multivariate analysis, 3 risk factors and 2 "sine qua non" conditions were used to build the decision algorithm. A risk score ≥ 4 required information on sperm cryopreservation before vasectomy, and those with a risk score ≥ 7 required extra time for reflection. The scoring system was proposed to 52 international experts and accepted with 86.7% strongly agreeing. The model's sensitivity and specificity were 0.98 and 0.53, respectively.
Conclusion: A decisional algorithm was established to identify patients requiring information on sperm cryopreservation before vasectomy or additional time for reflection to reduce the risk of vasectomy regret. The algorithm contains 3 risk factors and 2 "sine qua non" conditions.
期刊介绍:
Sexual Medicine is an official publication of the International Society for Sexual Medicine, and serves the field as the peer-reviewed, open access journal for rapid dissemination of multidisciplinary clinical and basic research in all areas of global sexual medicine, and particularly acts as a venue for topics of regional or sub-specialty interest. The journal is focused on issues in clinical medicine and epidemiology but also publishes basic science papers with particular relevance to specific populations. Sexual Medicine offers clinicians and researchers a rapid route to publication and the opportunity to publish in a broadly distributed and highly visible global forum. The journal publishes high quality articles from all over the world and actively seeks submissions from countries with expanding sexual medicine communities. Sexual Medicine relies on the same expert panel of editors and reviewers as The Journal of Sexual Medicine and Sexual Medicine Reviews.