Changes in Vasectomy Practice Patterns After Dobbs: A Multi-Institutional Study.

Abstract

Introduction: Following the Dobbs decision overruling Roe v Wade, public interest in vasectomies increased. This ruling directly affected urologic practice patterns and warrants further investigation. We aimed to conduct a multi-institutional study quantifying the change in vasectomy practice volume between the pre-Dobbs (PD) and after-Dobbs (AD) eras.

Methods: Multiple geographically distinct US academic medical centers participated in the study. Patients with an initial vasectomy consult between January 1, 2021, and December 31, 2022, were included and categorized as pre-Dobbs (January 1, 2021-June 24, 2022) and after-Dobbs (June 25, 2022-December 31, 2022). Dates of subsequent vasectomy procedures and patient demographic information were compared between the 2 groups.

Results: A total of 4326 initial vasectomy consults were analyzed. Among these, 3691 had subsequent vasectomies (2742 pre-Dobbs [152 cases/mo] vs 949 AD [158 cases/mo]). Men in the AD group were more likely to be younger (median age 38 years vs 39 years, P < .001), non-Hispanic White (68% vs 64%, P = .009), English speaking (94% vs 91%, P = .005), and privately insured (92% vs 89%, P = .008). The AD group also had fewer children (median number 2 [1-2] vs 2 [2-3], P < .001) and longer median wait time between the vasectomy consult and procedure (56 days vs 52, P < .001). Married men in the AD group were more likely to be childless (11% vs 5%, P < .001), as were single men (40% vs 23%, P < .001).

Conclusions: The Dobbs decision not only affected vasectomy volume nationwide but also the typical patient seeking a vasectomy. Urologists may need to adjust practice patterns to accommodate and educate the evolving vasectomy demographic.