(260) PATIENT SATISFACTION WITH VIRTUAL VERSUS IN-PERSON VASECTOMY CONSULTATIONS
Authors: Paradzinsky M , Ellison J , Sharda M , Jin Y , Sandlow J , Dietrich P 
Published: December 2024

Abstract

Introduction
Since the COVID-19 pandemic, there has been a rise in the use of telehealth pre-vasectomy consults. Several studies have demonstrated that rates of vasectomy completion do not seem affected by consultation type, suggesting that a pre-vasectomy physical exam is not necessary for successful procedure completion, which contrasts recommendations in the current American Urological Association vasectomy guidelines. While the current research offers a preliminary evaluation of the feasibility of virtual consultations for vasectomy, it has not included patient experiences with the consultation and the procedure.

Objective
We used data from post-procedure surveys of patients undergoing vasectomy at our institution to evaluate differences in patient preference and procedure experience by consultation type. We hypothesized that patients following vasectomy would be unlikely to regret their choice for having an in-person or virtual consultation. However, we suspected patients who had a virtual consultation would report greater subjective discomfort during vasectomy given the lack of physical exam prior to their procedure.

Methods
All patients being scheduled for vasectomy consultation with two fellowship-trained infertility specialists at our institution between October 1, 2022 to December 31, 2023 were given the option of an in-person or virtual visit. As these are done during the same clinic block, there was no difference in appointment availability based on consult modality. Patients were asked to complete post-procedure surveys assessing their satisfaction their procedure, procedural pain rating, preferred modality for the consultation, and anxiolytic use as a quality assurance initiative for our clinic. Demographic data and clinical characteristics were collected via retrospective chart review. Statistical analyses were performed using R Core Team (2024).

Results
A total of 169 patients completed post-procedure surveys, of which 76% were seen in-person while 24% were seen virtually. There was no difference in age, BMI, race, ethnicity, prior inguinal or scrotal surgical history, child status, or distance travelled to clinic between patients in either consultation type (Table 1). There was a statistically significant difference in anxiolytic use between the cohorts with 48% of patients seen in-person reporting use of pre-procedure diazepam versus only 30% of patients who had virtual consultations (p = 0.046). However, there were no demographic differences between patients based on anxiolytic use. Following vasectomy, only 5 (4.4%) of patients who had an in-person consult reported they would have preferred to have a virtual consult. In the virtual consult cohort, only 3 (8.6%) patients would have preferred an in-person consult. No statistical difference was observed between the groups regarding preference for alternate consult type (p = 0.39). There were no differences in pain rating or reported comfort with vas manipulation in patients who had an in-person versus virtual consult (p = 0.21 and p = 0.17, respectively).

Conclusions
Our study suggests that most patients still choose in-person consultations over virtual consultations for vasectomy despite equal availability to both. Patients reported similar satisfaction and pain scores regardless of their consultation method, either in-person or virtual, following their vasectomy. Virtual consultation can be offered without compromising patient experience.

Disclosure
No.