Do I need to see a urologist for my vasectomy?A comparison of practice patterns between urologists and family medicine physicians  

作　　者：Natasza M Posielski Daniel D Shapiro Xing Wang Brian V Le 

机构地区：[1]Department of Urology,University of Wisconsin,Madison,Wl 53705,USA [2]Department of Biostatistics,University of Wisconsin,Madison,Wl 53705,USA.

出　　处：《Asian Journal of Andrology》2019年第6期540-543,共4页亚洲男性学杂志（英文版）

摘　　要：Urologists perform the majority of vasectomies in the United States;however,family medicine physicians(FMPs)perform up to 35%.We hypothesized that d iff ere nces exist in practice patterns and outcomes between urologists and FMPs.Patie nts who underwent a vasectomy from 2010 to 2016 were identified.Postvasectomy semen analysis(PVSA)practices were compared between urologists and FMPs,before and after release of the 2012 AUA vasectomy guidelines.From 2010 to 2016,FMPs performed 1435(35.1%)of all vasectomies.PVSA follow-up rates were similar between the two groups(63.4%vs 64.8%,P=0.18).Of the patients with follow-up,the median number of PVSAs obtained was 1(range 1-6)in both groups(P=0.22).Following the release of guidelines,fewer urologists obtained multiple PVSAs(69.8%vs 28.9%pre-and post-2012,P<0.01).FMPs had a significant but lesser change in the use of multiple PVSAs(47.5%vs 38.4%,P<0.01).Both groups made appropriate changes in the timing of the first PVSA,but FMPs continued to obtain PVSAs before 8 weeks(15.0%vs 6.5%,P<0.01).FMPs had a higher rate of positive results in PVSAs obtained after 8 weeks,the earliest recommended by the AUA guidelines(4.1%vs 1.3%,P<0.01).Significant differences in PVSA utilization between FMPs and urologists were identified and were impacted by the release of AUA guidelines in 2012.In summary,FMPs obtained multiple PVSAs more frequently and continued to obtain PVSAs prior to the 8-week recommendation,suggesting less penetration of AUA guidelines to nonurology specialties.Furthermore,FMPs had more positive results on PVSAs obtained within the recommended window.

关 键 词：evidence-based PRACTICE family PRACTICE SEMEN analysis UROLOGIST VASECTOMY 

分 类 号：TB4[一般工业技术]