Pd37-12 a Contemporary Estimate of Vasectomy Failure in the United States: Analysis of Us Claims Data

You have accessJournal of UrologyInfertility: Epidemiology & Evaluation II (PD37)1 May 2024PD37-12 A CONTEMPORARY ESTIMATE OF VASECTOMY FAILURE IN THE UNITED STATES: ANALYSIS OF US CLAIMS DATA Albert S. Ha, Chiyuan A. Zhang, Shufeng Li, Michael Scott, Frank Glover, Satvir Basran, Francesco D. Giudice, and Michael L. Eisenberg Albert S. HaAlbert S. Ha , Chiyuan A. ZhangChiyuan A. Zhang , Shufeng LiShufeng Li , Michael ScottMichael Scott , Frank GloverFrank Glover , Satvir BasranSatvir Basran , Francesco D. GiudiceFrancesco D. Giudice , and Michael L. EisenbergMichael L. Eisenberg View All Author Informationhttps://doi.org/10.1097/01.JU.0001009464.98066.03.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Vasectomy is a common urologic procedure intended for sterilization. Vasectomy failure (VF) occurs in approximately 1:2000 men, with repeat vasectomy required in ≤1%. To date, such estimates have relied on historical cohorts. While traditionally a urologic procedure, vasectomies have increasingly been performed by other practitioners. In this study, we characterized contemporary trends in vasectomy utilization and failure in a large, administrative database. METHODS: Using IBM Marketscan® (2007-2021), we utilized ICD-9/10 and CPT codes to identify vasectomized men. Failure was defined as pregnancy ≥6 months post-procedure (pregnancy and birth rates were assessed by year of and time since vasectomy) or need for repeat vasectomy. Logistic regression was used to analyze factors associated with VF and repeat vasectomy. RESULTS: A total of 489,277 vasectomized men were identified, with a mean±SD of 38±6 years old. Most vasectomies were performed by urologists (n=344,139). Overall pregnancy and birth rates post-vasectomy were 2.26 and 1.24 per 1000-person years, respectively, with decreasing rates of failure with increased time post-procedure. Specifically, pregnancy rate was the highest in the first 4 months post-procedure (4.70 per 1000-person years) compared to later time periods. No significant trends of pregnancy and birth rates by year of procedure were seen. Furthermore, older age of the partner and year of procedure were associated with reduced odds of VF, while the lack of a post-vasectomy semen analysis (PVSA) increased odds (aOR: 1.16 [1.06-1.26]; p=0.0008). Men with vasectomy performed by non-urologists had increased odds of repeat procedure (aOR: 1.56 [1.40-1.74]; p<0.0001) (Table 1). CONCLUSIONS: The rate of VF, while low, was higher than previously reported, although significant differences were not seen over time. Factors such as older age of the partner and later years of vasectomy were associated with reduced odds of VF, while the absence of PVSA was associated with increased odds. The higher pregnancy rate in the months after vasectomy suggests an opportunity to improve patient counseling. Interestingly, non-Urology providers were associated with increased odds of repeat vasectomy. Further investigation will be necessary for improved clinical decision-making and patient counseling. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e805 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Albert S. Ha More articles by this author Chiyuan A. Zhang More articles by this author Shufeng Li More articles by this author Michael Scott More articles by this author Frank Glover More articles by this author Satvir Basran More articles by this author Francesco D. Giudice More articles by this author Michael L. Eisenberg More articles by this author Expand All Advertisement PDF downloadLoading ...