Adherence to american urological association (AUA) vasectomy guidelines: a systematic review of current practice among healthcare providers.

Abstract

Vasectomy, a common male sterilization procedure, has seen a surge in popularity following the 2022 reversal of Roe v. Wade. The American Urological Association (AUA) vasectomy guidelines provide essential guidance for providers, outlining best practices for the procedure. We reviewed studies that examined adherence to the AUA vasectomy guidelines with regard to pre-procedure counseling, surgical technique, and post vasectomy semen analysis (PVSA) practice, as well as studies evaluating the impact of these guidelines on urology and non-urology practices. A total of five studies were identified that assessed adherence to the guidelines. Only one of these studies evaluated adherence to all three aspects of the guidelines. The remaining four studies focused solely on the practice of PVSA. Overall, urologists exhibited greater adherence to the guidelines compared to other healthcare providers. However, the adherence rates were still suboptimal. Five additional studies were included that evaluated the use of home-based PVSA, which is not part of the AUA guidelines. Conflicting results were found regarding the test compliance. While the studies evaluating home-based PVSA may raise the question of including this approach in the guidelines panel discussion, it is important to consider the potential benefits and drawbacks before incorporating it as an option in future guidelines.