Decarbonizing urology: Carbon footprint assessment of a minimally invasive vasectomy in a French private hospital.

Introduction: The objective of this study was to assess the carbon footprint of a complete care pathway for minimally invasive vasectomy and to identify the main sources of greenhouse gas emissions, with the aim of proposing concrete strategies for reduction.

Materials and methods: Carbon emissions were calculated using the Bilan Carbone® methodology (ADEME), incorporating the following components: energy consumption, procurement, patient and staff transportation, food services, infrastructure and capital equipment, fugitive emissions, freight transport and waste management. Each stage of the care pathway - clinical consultations, surgical procedure, and postoperative semen analysis - was modeled. Emissions were expressed in kilograms of carbon dioxide equivalent (kgCO₂eq), based on emission factors from the Base Empreinte® and the Carebone® tool.

Results: The mean carbon footprint of a vasectomy care pathway was estimated at 73.42kgCO₂eq. Patient transportation accounted for the largest share of emissions (69.7%), followed by medical consumables (21.5%). The remaining categories, energy use, waste management, food, and staff transport, contributed less than 10% of total emissions combined.

Conclusion: Minimally invasive vasectomy is associated with a relatively low carbon footprint, primarily attributable to patient transportation and disposable medical supplies. Streamlining the care pathway - by performing the surgery in a procedure room, promoting teleconsultation, utilizing reusable equipment, and eliminating non-mandatory steps - could further reduce its environmental impact.

Level of evidence: 3: