Communications with patients
Five patients made early contact with the first author (median 3 days after vasectomy, range 1–7 days), three by text message, two by telephone.
How this fits in
Feedback after out-patient surgical procedures such as vasectomy may be difficult to obtain. Text messaging, used with appropriate care, can be a useful method of communication for surgical audit and can achieve a high percentage of patient compliance.
Fifty patients were sent text messages for audit purposes at a mean of 32 days after vasectomy (range 28–41 days). Forty-two responded to the first text. Four of the remaining eight patients replied to a second text message sent 11 days after the first text (range 5–24 days). Therefore, 46 (92%) of the 50 patients responded, 44 by text messaging, two by telephoning the first author. Thirty-nine of the patients responded on the day of receiving the text, seven patients between 1 and 5 days later.
Two patients made additional contact with the first author at a later stage.
Information received from patients
Two of the five patients who made early contact were concerned about minor wound bleeding. Two wished for advice about unexpectedly severe pain and tenderness, and one had developed a haemoserous wound discharge on the seventh postoperative day. The first author resolved these issues with advice by text or telephone; the patients with minor wound bleeding were reassured, the remaining three were advised to make an appointment with their GP. One of the patients with pain required unscheduled sick leave.
Forty-six patients responded to the planned text for audit. Although they had been advised during counselling that a brief answer would be sufficient, many replied at length and therefore some subjective analysis of the information provided has been required. Three additional text messages were sent by the first author to clarify issues raised, and three replies were received.
The 46 patients who responded included four of the five who had made early contact; two of these patients had made a good recovery and two had recovered from the initial problem but had developed further complications. Thirty-four of the remaining 42 patients, 74% of all responders, answered ‘No’ to the texted question, or gave an equivalent response indicating that they had had no problems, although 13 added supplementary comments to the effect that they had had symptoms such as discomfort, tenderness, or bruising, and six indicated that their skin sutures were still in situ. The remaining eight patients described problems varying from minor bleeding to clinically suspected scrotal infection (); five had been prescribed oral antibiotics by their GP, and one had been prescribed antibiotic cream for his wound. Three had required sick leave from work. Three patients had required attention for suture-related problems.
Problems following vasectomy described by patients (n = 14)
Of the two patients who contacted the first author after the planned exchange of text messages, one who had been well when texted on the 30th postoperative day had developed unilateral testicular swelling on the 41st day after vasectomy; the other patient requested general advice. Appropriate guidance was provided.
In summary, 14 patients reported problems at some stage after vasectomy: five who made early contact, eight at the time of audit by text, and one on the 41st postoperative day.