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Objectives: To determine if histological evaluation of the vasa is useful when post-vasectomy semen analysis (PVSA) compliance is low and to determine whether compliance could be predicted. Methods: A retrospective evaluation of patients undergoing vasectomy between 2018 and 2022 was undertaken. A comparison of the PVSA between three vasa histological categorisations was made: complete divisions, incomplete division(s), absent vas(a). A multivariate model was constructed to predict PVSA compliance. Results: From 388 patients, 191 (49.2%) undertook PVSA. Four patients had a revision of vasectomy. On 3 occasions this was due to the histology findings and once from semen analysis with normal histology. There was no significant difference in the number of azoospermic samples (95.4% vs 91.2%, ns), of samples with presence of Rare Non-Motile Sperm (RNMS) (2.6% vs 8.8%, ns) and those with sperm present (2.0 vs 0%, ns), between patients with complete division of the vasa on both sides and those with incomplete division on one side respectively. There was no difference in patient characteristics between those who complied with PVSA and those who did not. Conclusions: This paper suggests that there is a role for histological evaluation of the vasa when PVSA compliance is poor. Incompletely divided vasa on histology are not associated with an adverse PVSA. [ABSTRACT FROM AUTHOR]

Objectives: To determine if histological evaluation of the vasa is useful when post-vasectomy semen analysis (PVSA) compliance is low and to determine whether compliance could be predicted., Methods: A retrospective evaluation of patients undergoing vasectomy between 2018 and 2022 was undertaken. A comparison of the PVSA between three vasa histological categorisations was made: complete divisions, incomplete division(s), absent vas(a). A multivariate model was constructed to predict PVSA compliance., Results: From 388 patients, 191 (49.2%) undertook PVSA. Four patients had a revision of vasectomy. On 3 occasions this was due to the histology findings and once from semen analysis with normal histology. There was no significant difference in the number of azoospermic samples (95.4% vs 91.2%, ns), of samples with presence of Rare Non-Motile Sperm (RNMS) (2.6% vs 8.8%, ns) and those with sperm present (2.0 vs 0%, ns), between patients with complete division of the vasa on both sides and those with incomplete division on one side respectively. There was no difference in patient characteristics between those who complied with PVSA and those who did not., Conclusions: This paper suggests that there is a role for histological evaluation of the vasa when PVSA compliance is poor. Incompletely divided vasa on histology are not associated with an adverse PVSA.

Objectives: To define reference levels for intraoperative radiation during stent insertion, ureteroscopy (URS), and percutaneous nephrolithotomy (PCNL); to identify variation in radiation exposure between individual hospitals across the UK, between low- and high-volume PCNL centres, and between grade of lead surgeon., Patients/subjects and Methods: In all, 3651 patients were identified retrospectively across 12 UK hospitals over a 1-year period. Radiation exposure was defined in terms of total fluoroscopy time (FT) and dose area product (DAP). The 75th percentiles of median values for each hospital were used to define reference levels for each procedure., Results: Reference levels: ureteric stent insertion/replacement (DAP, 2.3 Gy/cm 2 ; FT, 49 s); URS (DAP, 2.8 Gy/cm 2 ; FT, 57 s); PCNL (DAP, 24.1 Gy/cm 2 ; FT, 431 s). Significant variations in the median DAP and FT were identified between individual centres for all procedures (P < 0.001). For PCNL, there was a statistically significant difference between DAP for low- (<50 cases/annum) and high-volume centres (>50 cases/annum), at a median DAP of 15.0 Gy/cm 2 vs 4.2 Gy/cm 2 (P < 0.001). For stent procedures, the median DAP and FT differed significantly between grade of lead surgeon: Consultant (DAP, 2.17 Gy/cm 2 ; FT, 41 s) vs Registrar (DAP, 1.38 Gy/cm 2 ; FT, 26 s; P < 0.001)., Conclusion: This multicentre study is the largest of its kind. It provides the first national reference level to guide fluoroscopy use in urological procedures, thereby adding a quantitative and objective value to complement the principles of keeping radiation exposure 'as low as reasonably achievable'. This snapshot of real-time data shows significant variation around the country, as well as significant differences between low- and high-volume centres for PCNL, and grade of lead surgeon for stent procedures., (© 2019 The Authors BJU International © 2019 BJU International Published by John Wiley & Sons Ltd.)