Original Research A baseline audit of post-vasectomy follow-up at three Cape Town district health facilities

Michael L. le Roux, Renaldo Christoffels, Roland Kroukamp, Jennie Morgan, Omotayo S. Alaofin, Tasleem Ras, Klaus B. von Pressentin

South African Family Practice | Vol 66, No 1 : Part 4| a6003 | DOI: https://doi.org/10.4102/safp.v66i1.6003 | © 2024 Michael L. le Roux, Renaldo Christoffels, Roland Kroukamp, Jennie Morgan, Omotayo S. Alaofin, Tasleem Ras, Klaus B. von Pressentin | This work is licensed under CC Attribution 4.0
Submitted: 03 July 2024 | Published: 04 October 2024

About the author(s) Michael L. le Roux, Division of Family Medicine, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Renaldo Christoffels, Metro Health Services, Western Cape Department of Health and Wellness, Cape Town, South Africa
Roland Kroukamp, Metro Health Services, Western Cape Department of Health and Wellness, Cape Town, South Africa
Jennie Morgan, Division of Family Medicine, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; and Metro Health Services, Western Cape Department of Health and Wellness, Cape Town, South Africa
Omotayo S. Alaofin, Division of Family Medicine, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Tasleem Ras, Division of Family Medicine, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Klaus B. von Pressentin, Division of Family Medicine, Department of Family, Community and Emergency Care, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa

Abstract

Background: Our study focuses on vasectomies, an underutilised contraception method worldwide. Little is known about post-vasectomy semen analysis (PVSA) adherence in our setting, which is an essential step in confirming the procedure’s success. We aimed to describe patient adherence to post-vasectomy follow-up and the success of procedures performed by different surgeon categories at three Cape Town district health facilities.

Methods: We conducted a retrospective descriptive audit. We extracted sociodemographic and procedural information from theatre records and patient folders. The PVSA results were retrieved from Groote Schuur Hospital’s Reproductive Medicine Unit.

Results: The records of 270 patients who underwent vasectomies in local district-level facilities from September 2016 to July 2021 were included. Only 122 (45.2%) semen analysis results were retrievable, of which 115 (94.2%) showed that the procedure was successful. Incomplete patient records significantly impacted the study. A data-collection instrument and implementing standardised stationery were developed, which some sites already use. These measures are designed to ensure more comprehensive datasets for future audits.

Conclusion: The study’s findings have identified flaws in record-keeping practices at the three study sites, a crucial step towards improving post-vasectomy care. Tracking procedural success and patient adherence to post-vasectomy semen analyses using the implemented stationery may assist future research and help drive quality improvement projects.

Contribution: This audit strengthens our understanding of improving this underutilised family planning option in the district health services. In partnership with the local teams, a revised clinical care pathway was developed to inform the delivery of an evidence-informed vasectomy service.

Keywords

vasectomy; clinical audit; quality improvement; access to healthcare; health services delivery; clinical governance; global surgery; primary care urology

Sustainable Development Goal

Goal 3: Good health and well-being

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