Background Vasectomy occlusive success is defined by the recommendation of ‘clearance’ to stop other contraception, and is elicited by post-vasectomy semen analysis (PVSA). We evaluated how the choice of either a postal or non-postal PVSA submission strategy was associated with compliance to PVSA and effectiveness of vasectomy. Methods We studied vasectomies performed in the UK from 2008 to 2019, reported in annual audits by Association of Surgeons in Primary Care members. We calculated the difference between the two strategies for compliance with PVSA, and early and late vasectomy failure. We determined compliance by adding the numbers of men with early failure and those given clearance. We performed stratified analyses by the number of test guidance for clearance (one-test/two-test) and the study period (2008–2013/2014–2019). Results Among 58 900 vasectomised men, 32 708 (56%) and 26 192 (44%) were advised submission by postal and non-postal strategies, respectively. Compliance with postal (79.5%) was significantly greater than with non-postal strategy (59.1%), the difference being 20.4% (95% CI 19.7% to 21.2%). In compliant patients, overall early failure detection was lower with postal (0.73%) than with non-postal (0.94%) strategy (−0.22%, 95% CI −0.41% to −0.04%), but this difference was neither clinically nor statistically significant with one-test guidance in 2014–2019. There was no difference in late failure rates. Conclusions Postal strategy significantly increased compliance to PVSA with similar failure detection rates. This resulted in more individuals receiving clearance or early failure because of the greater percentage of postal samples submitted. Postal strategy warrants inclusion in any future guidelines as a reliable and convenient option. Data are available upon reasonable request. The original data and the authors summary spreadsheets can be made available to any interested parties.

中文翻译：

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邮递和非邮递输精管结扎后精液样本提交策略对合规性和失败率的比较：对英国初级保健外科医生协会审计数据库的 11 年分析

背景 输精管结扎闭塞成功的定义是建议“清除”以停止其他避孕措施，并通过输精管结扎后精液分析 (PVSA) 得出。我们评估了邮寄或非邮寄 PVSA 提交策略的选择与 PVSA 的依从性和输精管结扎术的有效性之间的关系。方法 我们研究了 2008 年至 2019 年在英国进行的输精管切除术，并在初级保健外科医生协会成员的年度审计中报告。我们计算了两种策略在 PVSA 依从性以及早期和晚期输精管结扎失败方面的差异。我们通过将早期失败的男性人数和获得许可的人数相加来确定合规性。我们根据清除测试指南的数量（一次测试/两次测试）和研究期（2008-2013/2014-2019）进行了分层分析。结果 在 58 900 名接受输精管切除术的男性中，分别有 32 708 人（56%）和 26 192 人（44%）被建议通过邮寄和非邮寄方式提交。邮政（79.5%）的依从性显着高于非邮政策略（59.1%），差异为20.4%（95% CI 19.7%至21.2%）。在依从性患者中，邮政 (0.73%) 的总体早期失败检测率低于非邮政 (0.94%) 策略 (-0.22%, 95% CI -0.41% 至 -0.04%)，但这种差异既不是临床上的，也不是在 2014-2019 年的一次测试指导下具有统计学意义。后期失败率没有差异。结论 邮政策略显着提高了对 PVSA 的遵从性，并具有相似的故障检测率。由于提交的邮政样本比例更高，这导致更多的个人获得许可或提前失败。邮政策略保证将其作为可靠和方便的选择包含在任何未来的指南中。可根据合理要求提供数据。原始数据和作者摘要电子表格可供任何相关方使用。