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The percentage of men counseled by urologists who received a vasectomy mildly increased after the publication of the AUA vasectomy guideline

International Journal of Impotence Research (2024)Cite this article

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Abstract

This retrospective cohort study explored whether the publication of the vasectomy guideline by the American Urological Association in December 2012 increased the percentage of men counseled by urologists who received a vasectomy. We used commercial health insurance claims between 2010 and 2015 to identify the initial sterilization counseling visit for men aged 18–64 and whether each of them received a vasectomy within six months of that visit. A difference-in-differences analysis isolated the effect of the guideline on the percentage of men counseled by urologists who received a vasectomy, exploiting suspected variation in guideline exposure and adherence between urologists and non-urologists. In total, 226 012 men had an initial sterilization counseling visit, of which 182 204 (80.6%) were counseled by urologists and 43 808 (19.4%) were counseled by non-urologists. The percentage of men counseled by urologists who received a vasectomy mildly increased by 1.5% (p = 0.002) after the publication of the guideline. Therefore, the percentage of men who receive a vasectomy may in part be explained by practice guidelines and clinicians’ willingness to consider the procedure, and future research should investigate how clinicians arrive at their decisions to recommend a vasectomy and whether a standardized counseling protocol would ensure consistency.

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Fig. 1: Percentage of men counseled by urologists and non-urologists who received a vasectomy between 2010 and 2015.

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Data availability

The data that support the findings of this study are available from Merative US LP but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available.

Code availability

The code references data which are not publicly available, so it is not publicly available either.

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Acknowledgements

Not every individual who is eligible for a vasectomy may identify as a man. We acknowledge that the term “men” does not reflect every gender identity. Certain data used in this study were supplied by Merative US LP as part of one or more MarketScan Research Databases. Any analysis, interpretation, or conclusion based on these data is solely that of the authors and not Merative. The overturning of Roe v. Wade refers to the issuance of Dobbs v. Jackson Women’s Health Organization, NO 19-1392, 597 U. S. _ (2022). This research was internally funded.

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Authors and Affiliations

  1. The Center for Health and the Social Sciences, The University of Chicago, Chicago, IL, USA

    Max J. Hyman

  2. Pritzker School of Medicine, The University of Chicago, Chicago, IL, USA

    Zhong Huang

  3. Department of Surgery, Section of Urology, The University of Chicago Medical Center, Chicago, IL, USA

    Omer A. Raheem

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  1. Max J. Hyman
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  2. Zhong Huang
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  3. Omer A. Raheem
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Contributions

OR and MH proposed the study. MH and ZH designed the study. MH performed the statistical analysis. MH and ZH drafted the manuscript. All authors read and approved the final manuscript.

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Correspondence to Omer A. Raheem.

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The authors declare no competing interests.

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The University of Chicago Institutional Review Board exempted this study from full review because personal identifiable information was not available in these data.

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Hyman, M.J., Huang, Z. & Raheem, O.A. The percentage of men counseled by urologists who received a vasectomy mildly increased after the publication of the AUA vasectomy guideline. Int J Impot Res (2024). https://doi.org/10.1038/s41443-024-00829-2

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