(382) Understanding Low Vasectomy Follow-Through Rates in an Urban Urology Clinic: A Quality Improvement Initiative

Abstract Introduction Provider experience at our urban general Urology clinic has raised suspicion that vasectomy follow-through rates are below national averages. Understanding reasons for vasectomy cancellations may provide an avenue through which we can improve access to sexual medicine and reproductive healthcare in our community. Objective In this study, we assess the rate of follow-through with vasectomies in our community general urology clinic and identify barriers that our population frequently experiences. Using this information, we sought to design an intervention geared towards improving no-shows and cancellations. Methods We conducted a retrospective chart review of patients who had a vasectomy consultation at our clinic after March 2021 but had not undergone the procedure by September 2024. Reasons for cancellation were gathered via chart review and direct phone calls using a standardized script. Results Of the 97 men seeking vasectomy consultations, 33% (n=32) did not follow-through. Those who did not follow-through were older (39.6 vs. 36.2 years, p <0.05) and less likely to be single (6.3% vs. 13.9%), although the latter difference did not reach statistical significance (Table 1). Of the 32 patients we attempted to contact, 5 (15.6%) agreed to a qualitative interview. Four of five respondents were still interested in a vasectomy after their consultation but cited barriers including insurance coverage, scheduling difficulty, and a lack of social support (Table 2). Conclusions Roughly 1 in 3 men did not follow-through with having a vasectomy. Scheduling difficulties were the most common barrier, followed by lack of insurance and social support. In response to the collected data, targeted interventions to address these issues, including a customized informational video about the procedure and text message appointment reminders, have been implemented to help reduce vasectomy cancellation rates and improve future access to care. Follow-up assessment of vasectomy cancellation rates will be performed at 6 months to assess improvements with vasectomy cancellations. Disclosure No