Medical professional responsibility for postvasectomy pregnancy

详细信息    查看全文

• 作者：C. Vargas-Blasco^a ; ^b ; J. Arimany-Manso^a ; ^c ; E.L. Gó ; mez-Durá ; n^a ; ^d ; ^e ; ^{elgomezduran@comb.cat" class="auth_mail" title="E-mail the corresponding author} ; ^{elgomezduran@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; C. Martin Fumadó ; ^a ; ^e ; ^f ; M. Piqueras-Bartolomé ; ^b ; S. Capdevila-Querol^b ; A. Laborda-Rodriguez^b
• 关键词：Professional responsibility ; Malpractice ; Negligence ; Vasectomy ; Undesired pregnancy ; Urological surgical procedures
• 刊名：Actas Urológicas Espa?olas (English Edition)
• 出版年：2016
• 出版时间：July-August 2016
• 年：2016
• 卷：40
• 期：6
• 页码：400-405
• 全文大小：373 K

文摘

The follow-up of patients postvasectomy is frequently limited to a seminogram at 3 months if azoospermia is observed recanalization. This study evaluates a series of cases of complaints for postvasectomy pregnancy to establish follow-up recommendations that increase the clinical safety and reduce the risk of complaints.

Material and methods

We reviewed the database of the Department of Professional Responsibility of the Council of the College of Physicians of Catalonia, finding 28 complaints for postvasectomy pregnancy between 1992 and 2011. We analyzed the clinical and legal variables of the cases.

Results

A total of 13 extrajudicial complaints (46.43%), 13 civil lawsuits (46.43%) and 2 criminal lawsuits (7.14%) were recorded. Only 10 cases had a signed document of informed consent specific to vasectomy. In 26 cases, the data from the spermogram was available. A single spermogram was conducted in 20 cases (76.92%), 2 spermograms were conducted in 4 cases (15.38%) and none were performed in 2 cases (7.69%). For 9 of the cases (45%) where only a single spermogram was performed, the test was performed before 3 months postvasectomy. In 17 cases (65.38%), the result of the last spermogram was azoospermia, and 3 cases had oligospermia (11.54%). There were 2 failures of interpretation of the spermogram (7.69%) and 2 of normospermia (7.69%). In 2 cases, a spermogram was not performed (7.69%). Pregnancy occurred between 4 and 50 months after the intervention. In 12 cases (42.86%), it was considered that the practitioner was responsible.

Discussion

It is recommended that physicians emphasize (during the patient information stage) the possibility of spontaneous recanalisation and to request 2 spermograms, whose result should be azoospermia. Performing the test in the 3 months after vasectomy is risky, as is basing the waiting time on the number of ejaculations.