returned for the initial PVSA 458 (47.1%) never
returned for the second PVSA, 333 (34.3%) returned
for the second PVSA and 181 (18.6%) required 3 or
more PVSAs because sperm continued to be present
in the ejaculate. Of the 458 men with a single PVSA
who did not return for followup 348 (76.0%) were
azoospermic, 90 (19.7%) had RNMS, 7 (1.5%) had
greater than 100,000 nonmotile sperm per ml and
13 (2.8%) had motile sperm in the ejaculate. Due to
the retrospective nature of the study we did not
contact men with more than 100,000 nonmotile
sperm per ml or men with motile sperm who were
lost to followup. In all patients mean time between
the Frst and second PVSAs was 56.2 days (median
19) with a mean of 76.3 days (median 28) between
the second and third PVSAs.
The documented occlusive success rate in our
study population, as deFned by our andrology
laboratory protocol requiring 2 sequential PVSAs
conFrming azoospermia on a centrifuged pellet, was
34.7% (337 men) in those with at least 1 PVSA.
These data also represent patient compliance with
our recommended followup. Despite this low docu-
mented occlusive success rate and patient compli-
ance no unintended pregnancy was noted in the
cohort or reported by patients lost to followup. Thus,
the known contraceptive success rate was 100%.
vasectomy for persistent RNMS in the ejaculate
long after the vasectomy. In all 3 patients the last
PVSA revealed azoospermia on initial semen anal-
ysis and only identiFed RNMS on centrifuged pellet
analysis before repeat vasectomy. On subsequent
PVSA after repeat vasectomy 2 of the 3 patients
continued to show RNMS. Another PVSA was not
done thereafter in the third patient.
Findings at PVSA 1 to 3 in all patients.
, azoospermia, RNMS, greater than 100,000 nonmotile sperm and any motile sperm.
, azoospermia plus RNMS, indicating occlusive success according to AUA vasectomy guidelines, vs greater than 100,000
nonmotile sperm or any motile sperm.
IMPACT OF VASECTOMY GUIDELINES ON OUTCOMES