Men prefer pre-vasectomy consultation by telephone: a survey of vasectomized men

INTRODUCTION

Due to the COVID-19 pandemic teleconsultation was allowed as an insured service in the province of Quebec, Canada. We assessed the preferences of vasectomized patients for a pre-vasectomy consultation conducted in-person or by telephone.

MATERIALS AND METHODS

In September 2021, we sought the participation of 214 men who had their pre-vasectomy consultation over the phone to complete an anonymous three-item survey on their preferred modality for pre-vasectomy consultation. They completed their questionnaire in the waiting room of the vasectomy clinic just after the surgical procedure. We calculated the proportion and 95% confidence interval [CI] of patients preferring each modality. We assessed the difference in preference according to the distance between hometown and vasectomy clinic (< 25 km, 25-50 km, and > 50 km) with Fisher's exact test.

RESULTS

Participation rate was 98% (n = 209/214). Most patients would have preferred telephone over in-person pre-vasectomy consultation if they had been given a choice (96%; 95% CI 92% to 98%), if they had had to recommend a modality to a friend (95%; 95% CI 91% to 98%), and if they had had to do a pre-vasectomy consultation again (prefer or no preference; total 97%; 95% CI 94% to 99%). Distance between hometown and vasectomy clinic did not significantly influence their preferences (p > 0.29 for each of the three items).

CONCLUSIONS

Vasectomized men preferred having pre-vasectomy consultation by telephone instead of in person. If maintained as an insured service after the COVID-19 pandemic, Canadian physicians offering vasectomy services should consider making this service available to their patients.

Foraging habitat of North Atlantic right whales has declined in the Gulf of St. Lawrence, Canada, and may be insufficient for successful reproduction

Climate-induced changes in calanoid copepod (Calanus spp.) availability in traditional feeding areas might explain why a large proportion of the North Atlantic right whale Eubalaena glacialis population has fed in the Gulf of St. Lawrence (Canada) in recent years. However, little is known about the distribution of copepods in the gulf, and whether their abundance is sufficient to energetically sustain right whales. We used a mechanistic modelling approach to predict areas within the gulf that have foraging potential for adult female right whales, based on the annual energetic needs of resting, pregnant and lactating females, and their theoretical prey density requirements. We identified suitable foraging areas for right whales by coupling a foraging bioenergetics model with a 12 yr data set (2006-2017) describing the abundance and 3-dimensional distribution of late-stage Calanus spp. in the gulf. Prey densities in the southern gulf (from Shediac Valley to the Magdalen Islands) supported all 3 reproductive states in most (≥6) years. However, foraging habitat became progressively sparse in the southern gulf over time, with noticeably less suitable habitat available after 2014. Few other potentially suitable foraging areas were identified elsewhere in the gulf. Overall, the availability of foraging habitat in the gulf varied considerably between years, and was higher for resting females than for pregnant and lactating females. Our findings are consistent with the recent low calving rates, and indicate that prey biomass in the Gulf of St. Lawrence may be insufficient in most years to support successful reproduction of North Atlantic right whales.

Predicting seasonal occurrence of leatherback turtles (Dermochelys coriacea) in eastern Canadian waters from turtle and ocean sunfish (Mola mola) sighting data and habitat characteristics

Part of the western Atlantic population of leatherback turtles (Dermochelys coriacea (Vandelli, 1761)) forage in Canadian waters, where high-use areas have been identified using satellite telemetry and opportunistic sightings. Here, we use sightings of leatherback turtles and ocean sunfish (Mola mola (Linnaeus, 1758)) obtained during a systematic large-scale aerial survey, along with opportunistic turtle sightings, to examine the seasonal occurrence and distribution of leatherback turtles in eastern Canada. Using environmental correlates, we predict the spatial and seasonal development of potentially suitable habitats. All data sets confirmed the presence of leatherback turtles off Nova Scotia during summer. They also highlighted turtle occurrence off southern Newfoundland. Opportunistic sightings suggest a seasonal shift in main turtle concentrations from southwest to northeast, with use of southern Newfoundland waters extending into September. A generalized additive model linking environmental characteristics and turtle observations suggests adding the Grand Banks off Newfoundland and waters east of Anticosti Island in the Gulf of St. Lawrence to the potentially important habitat for leatherback turtles. Direct observations helped delineate habitat currently used by leatherback turtles. In the context of climate change, this modelling approach may improve our ability to forecast changes in turtle habitat suitability and the risks of entrapment or collision associated with potentially changing usage patterns.

Unilateral absence of vas deferens: prevalence among 23.013 men seeking vasectomy

Purpose:

To determine the prevalence of unilateral absence of vas deferens (UAVD) in men with both testes seeking vasectomy.

Materials and Methods:

Computerized charts of 23,013 patients encountered between January 1994 and December 2013 in one university hospital and two community clinics of Quebec City, Canada, were searched. Pre-vasectomy consultation, operative reports and semen analysis results were reviewed to identify cases of UAVD. Cases were categorized as confirmed (unilateral vasectomy and success confirmed by semen analysis) or possible congenital UAVD further sub-categorized according to whether or not a scrotal anomaly was present.

Results:

Among 159 men identified as potentially having UAVD, chart review revealed that 47 had only one testicle, 26 had bilateral vasa, and four were misdiagnosed (post-vasectomy semen analysis [PVSA] showing motile sperm after unilateral vasectomy) leaving 82 men deemed cases of UAVD (0.36%, 95% confidence interval 0.28% to 0.43%). These were classified as confirmed (n=48, 0.21%) and possible (n=34, 0.15%; 22 without and 12 with scrotal anomalies) congenital UAVD. The misdiagnosis ratio of UAVD was low when scrotal content was otherwise normal (1:48), but higher if anomalies were present (3:12).

Conclusions:

Most surgeons who perform vasectomy will encounter cases of UAVD. In most suspected cases, it is safe and effective to proceed with unilateral vasectomy under local anesthesia while stressing the need for PVSA. Further studies or scrotal exploration may be considered in patient with prior scrotal surgery.