Resumo:
En
|
Texto:
En
|
PDF:
En
ABSTRACT Objectives: To estimate the risk of post-vasectomy infections in various settings and across various surgical techniques and sanitization practices. Patients and Methods: Retrospective review of the records of 133,044 vasectomized patients from four large practices/network of practices using the no-scalpel vasectomy (NSV) technique in Canada (2011-2021), Colombia (2015-2020), New Zealand (2018-2021), and the United Kingdom (2006-2019). We defined infection as any mention in medical records of any antibiotics prescribed for a genital or urinary condition following vasectomy. Results: Post-vasectomy infection risks were 0.8% (219 infections/26,809 procedures), 2.1% (390/18,490), 1.0% (100/10,506), and 1.3% (1,007/77,239) in Canada, Colombia, New Zealand, and the UK, respectively. Audit period comparison suggests a limited effect on the risk of infection of excising a short vas segment, applying topical antibiotic on scrotal opening, wearing a surgical mask in Canada, type of skin disinfectant, and use of non-sterile gloves in New Zealand. Risk of infection was lower in Colombia when mucosal cautery and fascial interposition [FI] were used for vas occlusion compared to ligation, excision, and FI (0.9% vs. 2.1%, p<0.00001). Low level of infection certainty in 56% to 60% of patients who received antibiotics indicates that the true risk might be overestimated. Lack of information in medical records and patients not consulting their vasectomy providers might have led to underestimation of the risk. Conclusion: Risk of infection after vasectomy is low, about 1%, among international high-volume vasectomy practices performing NSV and various occlusion techniques. Apart from vasectomy occlusion technique, no other factor modified the risk of post-vasectomy infection. Objectives postvasectomy post Methods 133044 133 044 133,04 practicesnetwork network noscalpel scalpel (NSV 20112021, 20112021 2011 2021 , (2011-2021) 20152020, 20152020 2015 2020 (2015-2020) 20182021, 20182021 2018 (2018-2021) 20062019. 20062019 2006 2019 . (2006-2019) Results Postvasectomy Post 08 0 8 0.8 219 (21 infections26809 26 809 infections/26,80 procedures, procedures procedures) 21 2 1 2.1 390/18,490, 39018490 390/18,490 390 18 490 (390/18,490) 10 1.0 100/10,506, 10010506 100/10,506 100 506 (100/10,506) 13 3 1.3 1,007/77,239 100777239 007 77 239 (1,007/77,239 UK respectively segment opening disinfectant nonsterile non sterile [FI ligation excision 0.9% 09 9 (0.9 vs p<0.00001. p000001 p p<0.00001 00001 p<0.00001) 56 60 overestimated Conclusion low 1% highvolume high volume 13304 04 133,0 2011202 201 202 (2011-2021 2015202 (2015-2020 2018202 (2018-2021 2006201 200 (2006-2019 0. (2 infections2680 80 infections/26,8 2. 3901849 390/18,49 39 49 (390/18,490 1. 1001050 100/10,50 50 (100/10,506 1,007/77,23 10077723 00 7 23 (1,007/77,23 0.9 (0. p00000 p<0.0000 0000 5 6 1330 133, 201120 20 (2011-202 201520 (2015-202 201820 (2018-202 200620 (2006-201 ( infections268 infections/26, 390184 390/18,4 4 (390/18,49 100105 100/10,5 (100/10,50 1,007/77,2 1007772 (1,007/77,2 (0 p0000 p<0.000 000 20112 (2011-20 20152 (2015-20 20182 (2018-20 20062 (2006-20 infections26 infections/26 39018 390/18, (390/18,4 10010 100/10, (100/10,5 1,007/77, 100777 (1,007/77, p000 p<0.00 (2011-2 (2015-2 (2018-2 (2006-2 infections2 infections/2 3901 390/18 (390/18, 1001 100/10 (100/10, 1,007/77 10077 (1,007/77 p00 p<0.0 (2011- (2015- (2018- (2006- infections/ 390/1 (390/18 100/1 (100/10 1,007/7 1007 (1,007/7 p0 p<0. (2011 (2015 (2018 (2006 390/ (390/1 100/ (100/1 1,007/ (1,007/ p<0 (201 (200 (390/ (100/ 1,007 (1,007 p< (20 (390 (100 1,00 (1,00 (39 (10 1,0 (1,0 (3 (1 1, (1,