Article Text
Abstract
Introduction A semen analysis is recommended three months after vasectomy to assess the success of the procedure. However, typically in North America, only 55–71% of vasectomized men comply with the prescribed test. According to the Ottawa Decision Support Model (ODSM), deciding whether to do a post- vasectomy semen analysis (PVSA) or not is a ’difficult’ decision. Our study aimed to create a patient decision aid (PtDA) and implement it in the practice of Vasectomie Québec, Canada’s most important vasectomy provider.
Methodology The development of the PtDA was based on the ODSM framework and the International Patient Decision Aid Standards (IPDAS) criteria, using the literature on the determinants of compliance to PVSA and Vasectomie Québec statistics on the effectiveness of vasectomy.
Results The PtDA provides information on PVSA, vasectomy success/failure probabilities (including a pictogram), reasons for choosing to do the test or not, and resources to facilitate an informed decision. It was tested with 57 vasectomized men at Vasectomie Québec. Men regarded the PtDA as informative (95%) and helpful in understanding the merits and drawbacks associated with each option (98%). It facilitated clarification of their priorities (93%), the certainty of their decision (89%), and their deliberation (90%). Respondents expressed satisfaction with the tool, citing its user-friendliness (90%), clear presentation (98%), and appropriate font length (81%) and size (94%). Most reported that the language (98%) and statistical information (96%) were clear and easy to understand. Between October 2022 and September 2023, Vasectomie Québec supplied the final PtDA to over 4,700 vasectomized men.
Conclusion A PtDA on PVSA was successfully developed and implemented in a large vasectomy clinic in Canada. It could be adapted to other settings according to their success/failure statistics and access to PVSA. An evaluation of the impact of the PtDA on decision-making and compliance is underway.