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

Importance: Following the Dobbs decision overruling Roe vs. Wade, public interest in vasectomies increased. This ruling directly impacted urologic practice patterns, and warrants further investigation.

Objective: To conduct a multi-institutional study quantifying the change in vasectomy practice volume between the pre-Dobbs (PD) and after-Dobbs (AD) eras.

Design: Multiple geographically distinct US academic medical centers participated in the study. Patients with an initial vasectomy consult between 1/1/2021 and 12/31/22 were included and categorized as pre- (1/1/21 - 6/24/22) or after-Dobbs (6/25/22 - 12/31/22). Dates of subsequent vasectomy procedure and patient demographic information were compared between the two groups.

Results: A total of 4326 initial vasectomy consults were analyzed. Among these, 3691 had subsequent vasectomies (2742 PD (152 cases per month) vs. 949 AD (158 cases per month)). Men in the AD group were more likely to be younger (median age 38 years vs. 39, P<0.001), non-Hispanic white (68% vs. 64%, P=0.009), English-speaking (94% vs. 91%, P=0.005), and privately insured (92% vs. 89%, P=0.008). The AD group also had fewer children (median number 2 [1-2] vs. 2[2-3], P<0.001) and longer median wait between vasectomy consult and procedure (56 days vs. 52, P<0.001). Married men in the AD group were more likely to be childless (11% vs. 5%, P<0.001), as were single men (40% vs. 23%, P<0.001).

Conclusion: 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 as well as to educate the evolving vasectomy demographic.