Abstract
Objective
To describe trends in the characteristics of urologic surgeons performing vasectomy
over time.
Methods
We performed a retrospective, cross-sectional study examining surgeon characteristics
for case logs from the American Board of Urology between 2004 and 2013. We used generalized
estimating equations with a log link and negative binomial distribution to examine
demographic differences (gender, rural location, and surgeon volume) in the number
of vasectomies surgeons performed over time.
Results
Between 2004 and 2013, 5316 urologists had case logs collected within the 7-month
certification window. The majority of these surgeons self-identified as general urologists
(82.8%), and a small proportion identified as andrology and infertility specialists
(1.7%). Across all years, the median number of vasectomies performed per certifying
surgeon during the study period was 14 (interquartile range 6-26). The majority of
vasectomies were performed by high-volume surgeons (≥ 26 vasectomies) ranging from
49.2% to 66.9% annually, whereas the proportion performed by low-volume (≤ 5 vasectomies)
surgeons ranged from 3.3% to 6.6% annually. Male surgeons performed vasectomies 2.20
times more frequently than female surgeons (95% confidence interval 1.93-2.49; P <.0001) across the study period with no evidence to suggest this gap changed over
time (gender-year interaction 1.01 [95% confidence interval: 0.97-1.06; p = .576]).
Conclusion
While the majority of urologists performing vasectomy identify as general urologists,
there appears to be a focus on vasectomy practice among a small number of high-volume
surgeons. Furthermore, while the number of female surgeons performing vasectomies
increased, a gender gap persists in the proportion of vasectomies performed by females.
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References
- Demographics of vasectomy–USA and international.Urol Clin North Am. 2009; 36: 295-305
- Vasectomy in the United States, 1991 and 1995.Am J Public Health. 1999; 89: 92-94
- The “top 10” urological procedures: a study of hospital episodes statistics 1998-99.BJU Int. 2002; 90: 1-6
- Vasectomy demographics and postvasectomy desire for future children: results from a contemporary national survey.Fertil Steril. 2013; 99: 1880-1885
- Surgical sterilization among US men and women with employer-based insurance: a claims data analysis.Contraception. 2018; 98: 247-251
- Consultant surgeons and vasectomy.Br Med J. 1973; 2: 629-634
- Changes in practice patterns in male infertility cases in the United States: the trend toward subspecialization.Fertil Steril. 2018; 110: 76-82
- The gender divide: the impact of surgeon gender on surgical practice patterns in urology.J Urol. 2016; 196: 1522-1526
- Surgical practice patterns for male urinary incontinence: analysis of case logs from certifying American urologists.J Urol. 2012; 188: 205-210
- Midurethral sling is the dominant procedure for female stress urinary incontinence: analysis of case logs from certifying American urologists.Urology. 2013; 82: 1267-1271
- Temporal trends and practice patterns in the urology work force between low and high density population areas.Urol Pract. 2017; 4: 91-95
- The effect of minimally invasive prostatectomy on practice patterns of American urologists.Urol Oncol. 2016; 34: 255.e1-255.e5
- Systematic review of the volume-outcome relationship for radical prostatectomy.Eur Urol Focus. 2018; 4: 775-789
- Hospital volume and perioperative outcomes for radical cystectomy: a population study.BJU Int. 2017; 119: 26-32
- Gender representation in urologic subspecialties.Urology. 2018; 114: 66-70
- Women urologists: changing trends in the workforce.Urology. 2016; 91: 1-5
- Women in urology residency, 1978-2013: a critical look at gender representation in our specialty.Urology. 2016; 92: 20-25
- Do women work less than men in urology: data from the american urological association census.Urology. 2018; 118: 71-75
- Do urology male patients prefer same-gender urologist?.Am J Mens Health. 2018; 12: 1379-1383
- Gender preferences for urologists: women prefer female urologists.Urol J. 2017; 14: 3018-3022
- Patients’ preference for gender of urologist.Int J Clin Pract. 2005; 59: 526-528
- What's gender got to do with it: difference in the proportion of traditionally female cases performed by general urologists of each gender.Urology. 2018; 116: 35-40
- Projecting the urology workforce over the next 20 years.Urology. 2016; 98: 21-26
- Forecasting limited access to urology in rural communities: analysis of the american urological association census.J Rural Health. 2019; (Epublished ahead of print)
- Changes in pelvic organ prolapse surgery in the last decade among United States urologists.J Urol. 2014; 191: 1022-1027
- Contemporary open and robotic radical prostatectomy practice patterns among urologists in the United States.J Urol. 2012; 187: 2087-2092
- Do I need to see a urologist for my vasectomy? A comparison of practice patterns between urologists and family medicine physicians.Asian J Androl. 2019; 21: 540-543
Article info
Publication history
Published online: April 21, 2020
Accepted:
April 5,
2020
Received:
December 16,
2019
Footnotes
Conflict of Interest: Authors declare that they have no conflict of interest.
Source of Funding: Research reported in this publication was supported, in part, by the National Institutes of Health's National Center for Advancing Translational Sciences, Grant Number UL1TR001422. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
