TY - JOUR
T1 - National Characteristics of Surgeons Performing Vasectomy
T2 - Increasing Specialization and a Persistent Gender Gap
AU - Halpern, Joshua A.
AU - Zumpf, Katelyn B.
AU - Keeter, Mary Kate
AU - Tatem, Alexander J.
AU - Kahn, Barbara E.
AU - Bennett, Nelson E.
AU - Welty, Leah J.
AU - Brannigan, Robert E.
N1 - Funding Information:
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.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/9
Y1 - 2020/9
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85087977414&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85087977414&partnerID=8YFLogxK
U2 - 10.1016/j.urology.2020.04.016
DO - 10.1016/j.urology.2020.04.016
M3 - Article
C2 - 32325136
AN - SCOPUS:85087977414
SN - 0090-4295
VL - 143
SP - 130
EP - 136
JO - Urology
JF - Urology
ER -