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Introduction: Post-vasectomy semen analysis (PVSA) completion rates after vasectomy are poor, and minimizing the need for an additional in-person visit may improve compliance. We hypothesized that providing PVSA specimen cup at time of vasectomy instead of at a postoperative appointment might be associated with higher PVSA completion rates. We also hypothesized that performing virtual postoperative visits after vasectomy might improve PVSA completion rates. Objective: To evaluate PVSA completion rates between patients receiving specimen cups at time of vasectomy versus at post-operative appointment. Methods: We performed a retrospective review of all patients seen by a single provider for vasectomy consultation between October 2016 and June 2022. All patients who underwent vasectomy were included. Patients who underwent vasectomy prior to May 2020 had PVSA specimen cup given at postoperative appointment and those who underwent vasectomy after May 2020 were given PVSA specimen cup at time of vasectomy. PVSA completion and postoperative visit type were recorded. Demographic and clinical outcomes data were collected. Logistic regressions were used to investigate associations between PVSA completion rates and both timing of providing PVSA specimen cup and postoperative visit setting. Results: 491 patients were seen for vasectomy consultation between October 2016 and June 2022. 370 (75.4%) of all patients seen for consultation ultimately underwent vasectomy. 173 (45.7%) patients underwent vasectomy prior to May 2020 and were given PVSA specimen cup at postoperative visit. 197 (53.2%) patients underwent vasectomy after May 2020 and were given PVSA specimen cup at vasectomy. 160 (47.2%) of patients were seen virtually for postoperative visit, whereas 179 (52.8%) were seen in-person. Providing PVSA specimen cup at time of vasectomy was associated with higher odds of PVSA completion than providing PVSA specimen cup at postoperative visit (62.4% vs. 49.7%; OR = 1.68; 95% CI: 1.11, 2.55). No association was noted between PVSA completion rate and whether the postoperative visit was virtual or in-person (63.8% vs. 55.3%; OR = 1.42; 95% CI: 0.92, 2.20). Conclusions: PVSA specimen cup provided at time of vasectomy versus at postoperative appointment is associated with higher rates of PVSA completion. Virtual postoperative visit after vasectomy is feasible and has no detectable association with PVSA completion rates. These findings together support the growing role of telehealth in urology practices. Disclosure: No. [ABSTRACT FROM AUTHOR]

Background: The utilization of penile prosthesis (PP) insertion in the general population for medically refractory erectile dysfunction (ED) has not been well-characterized. This study assessed the national temporal trends in the surgical management of ED utilizing PP., Materials and Methods: An analysis of the 5% Medicare Public Use Files from 2001 to 2010 was performed to assess the use of PP. Regression analysis was performed to identify factors associated with PP placement, type of PP utilized, and factors associated with revisions., Results: A total of 1,763,260 men were diagnosed with ED, 3% (53,180) of whom underwent PP insertion. The utilization of PP for ED decreased from 4.6% in 2002 to 2.3% in 2010 (P < 0.01). This temporal decline in utilization was significant across all demographic factors including age, ethnicity, and geographic location. Men aged 65-74, from the U.S. South and West, and those with Charlson comorbidity scores >1 were more likely to have a PP inserted for ED (P < 0.01). African American men were more likely to have a semirigid PP placed compared with a multicomponent inflatable PP, and were more likely to undergo a revision or removal of the PP compared with Caucasian men (P < 0.01)., Conclusions: The surgical management of ED with PP changed significantly between 2001 and 2010. The overall utilization of PP decreased, but its use in patients with significant medical comorbidities increased. Age >65, ethnicity, and geography influenced the likelihood of PP placement, prosthesis type, as well as the likelihood of prosthesis removal or revision., (© 2015 International Society for Sexual Medicine.)