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Michael L Eisenberg - One of the best experts on this subject based on the ideXlab platform.
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Vasectomy utilization in men aged 18 45 declined between 2002 2017 results from the united states national survey for family growth data
Journal of Andrology, 2021Co-Authors: Xinyuan Zhang, Michael L EisenbergAbstract:BACKGROUND Vasectomy remains a safe, simple and effective contraceptive options. Conflicting data on the trend of Vasectomy use among men have been described previously at various snapshots in time over the last two decades. OBJECTIVES This paper seeks to describe the trend of Vasectomy utilization in the last 15 years using a nationally representative United States survey. MATERIALS AND METHODS We analyzed data from male respondents aged 18 to 45 years of the Cycle 6 (2002), 2006-2010, 2011-2013, 2013-2015, and 2015-2017 National Survey of Family Growth (NSFG) surveys. Population estimates are calculated based on the official NSFG instructions, accounting for the complex survey design. Multivariate logistic regression models are used to study demographic and socioeconomic factors associated with Vasectomy use in men. RESULTS Baseline characteristics for men undergoing Vasectomy do not differ significantly across survey years. Increased age, White race, marital status, higher education level, birthplace within the United States, higher household income, non-Catholic affiliation, and higher number of biological kids have significant positive associations with Vasectomy use. After accounting for factors associated with Vasectomy utilization, there was a significant temporal decline in Vasectomy utilization rates in all age groups across survey years which remained in subgroup analyses of all men greater than 25, 30, and 35 of age. DISCUSSION This is the first population-based analysis of US data to observe a decline in Vasectomy utilization over the past two decades. The decline was statistically significant after accounting for all demographic and socioeconomic factors. CONCLUSION There is a steady decline in the prevalence of Vasectomy use in men from 2002 to 2017. Given the limited contraceptive options for men and the importance of contraception and family planning in the US, further research is needed to understand the temporal decline. This article is protected by copyright. All rights reserved.
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Vasectomy and the risk of prostate cancer in a prospective us cohort data from the nih aarp diet and health study
Journal of Andrology, 2019Co-Authors: Michael T Davenport, Chiyuan A Zhang, John T Leppert, James D Brooks, Michael L EisenbergAbstract:Background Several studies have linked Vasectomy with the risk of prostate cancer; however, this association has been attributed to selection bias. Since Vasectomy is a common and effective form of contraception, these implications are significant. Therefore, we sought to test this association in a large observational cohort. Objective To evaluate the potential association between prior Vasectomy and the risk of developing prostate cancer. Materials and methods We evaluated the relationship between Vasectomy and prostate cancer in the NIH-AARP Diet and Health Study. Of the 111,914 men, prostate cancer was identified in 13,885 men and vasectomies were performed in 48,657. We used multivariate analysis to examine the relationship between prostate cancer and Vasectomy. We also performed propensity score-adjusted and propensity score-matched analysis. Results Men utilizing Vasectomy were more likely to be ever married, fathers, educated, white, and screened for prostate cancer. During 4,251,863 person-years of follow-up, there was a small association between Vasectomy and incident prostate cancer with a hazard ratio of 1.05 (95% CI, 1.01-1.11). However, no significant association was found when looking separately at prostate cancer by grade or stage. Conclusions were similar when using propensity adjustment and matching. Importantly, a significant interaction between Vasectomy and PSA screening was identified. Discussion Estimates of the association between Vasectomy and prostate cancer are sensitive to analytic method underscoring the tenuous nature of the connection. Given the differences between men who do and do not utilize Vasectomy, selection bias appears likely to explain any identified association between Vasectomy and prostate cancer. Conclusions With over 20 years of follow-up, no convincing relationship between Vasectomy and prostate cancer of any grade was identified.
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use of secondary contraception following Vasectomy insights from the pregnancy risk assessment monitoring system 2007 2011
Translational Andrology and Urology, 2018Co-Authors: Darshan P Patel, Denise J Jamieson, Letitia Williams, Lee Warner, Mary Elizabeth Oneil, Kenneth I Aston, Douglas T Carrell, Violanda Grigorescu, John R Gannon, Michael L EisenbergAbstract:Background: To assess postpartum use of secondary contraception with Vasectomy within Pregnancy Risk Assessment Monitoring System (PRAMS). Methods: Secondary contraception and type of method used were assessed among married women reporting partner Vasectomy 4 months after a recent live birth in female residents of 15 US states and New York City who participated in the 2007–2011 PRAMS. Results: Between 2007 and 2011, 1,004 married women who had a recent live birth participating in PRAMS reported they and their partners relied on Vasectomy for postpartum contraception. Among these couples, 57.8% reported not using additional forms of contraception postpartum. Of those reporting additional contraception, condoms were most commonly used (50.0%), followed by oral contraceptive pills (26.5%), and withdrawal (9.5%). Multivariable modeling showed that use of secondary contraception was twice as high among women reporting a second birth versus women reporting a fourth or higher birth [adjusted prevalence odds ratio (POR) =2.0 (1.1–3.2)]. No other sociodemographic characteristics (maternal age, maternal race, parental education, household income) were significantly associated with use of secondary contraception with Vasectomy. Conclusions: Most couples within PRAMS reporting partner Vasectomy as postpartum contraception did not use secondary contraception in the months immediately after Vasectomy, and, of those who did, most relied on less effective methods. Clinicians need to better understand reasons for limited use of secondary contraception with Vasectomy to improve counseling strategies for reducing unintended pregnancy.
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the relationship between offspring sex ratio and Vasectomy utilization
Urology, 2017Co-Authors: Remy W Lamberts, David P Guo, Michael L EisenbergAbstract:Objective To determine if there was an association between Vasectomy utilization and offspring sex ratio (male offspring : total offspring), as offspring sex preference may have an impact on family planning in the United States. Methods Using data from the National Institutes of Health-AARP Diet and Health Study, we calculated the number of sons and daughters of all men stratified by Vasectomy status. We utilized a logistic regression model to determine if Vasectomy utilization varies based on offspring sex ratio while accounting for known factors that impact Vasectomy utilization. Results Of these men, 30,927 (30.8%) underwent Vasectomy. Marital status, race, age, education level, region or state, and number of offspring were all significantly correlated with Vasectomy utilization (P < .01). The sex ratio for vasectomized fathers (51.3%) was significantly higher than for fathers who had not undergone Vasectomy (50.7%, P < .01). This difference remained even after we stratified by the total number of offspring: vasectomized men with 4 or more children had a sex ratio of 947 girls per 1000 boys, whereas the no Vasectomy group had a sex ratio of 983 girls per 1000 boys (P < .01). For men with at least 2 children, each additional son increased the likelihood of Vasectomy by 4% (P < .01), whereas each additional daughter led to a 2% decrease in Vasectomy utilization (P = .03). Conclusion Vasectomized fathers have a higher proportion of sons compared with non-vasectomized fathers, suggesting that offspring sex ratio is associated with a man's decision to undergo Vasectomy. Further research is indicated to understand how offspring sex ratio impacts a man's contraceptive decisions.
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racial differences in Vasectomy utilization in the united states data from the national survey of family growth
Urology, 2009Co-Authors: Michael L Eisenberg, Jillian T Henderson, John K Amory, James F Smith, Thomas J WalshAbstract:Objectives To explore whether health care, socioeconomic, or personal characteristics account for disparities observed in the utilization of Vasectomy. More than 500 000 vasectomies are performed annually in the United States. The safety and efficacy of Vasectomy make it a good family planning option, yet the factors related to use of male surgical sterilization are not well understood. In this analysis, we examined differences in Vasectomy rates according to factors such as race and socioeconomic status. Methods We analyzed data from the male sample of the 2002 National Survey of Family Growth to examine the use of Vasectomy among the sample of men aged 30-45 (n = 2161). Demographic, socioeconomic, and reproductive characteristics were analyzed to assess associations with Vasectomy. Results About 11.4% of men aged 30-45 years reported having a Vasectomy, representing approximately 3.6 million American men. Although 14.1% of white men had a Vasectomy, only 3.7% of black and 4.5% of Hispanic men reported undergoing Vasectomy. On multivariate analysis, a significant difference in the odds of Vasectomy by race/ethnicity remained, with black (odds ratio = 0.20, 0.09-0.45) and Hispanic men (odds ratio = 0.41, 0.18-0.95) having a significantly lower rate of Vasectomy independent of demographic, partner, and socioeconomic factors. Having ever been married, fathering 2 or more children, older age, and higher income were the factors associated with Vasectomy. Conclusions After accounting for reproductive history, partner, and demographic characteristics, black and Hispanic men were less likely to rely on Vasectomy for contraception. Further research is needed to identify the reasons for these race/ethnic differences and to identify factors that impede minority men's reliance on this means of fertility control.
Ashley L White - One of the best experts on this subject based on the ideXlab platform.
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a qualitative exploration of men s perceptions of the terms male sterilization versus Vasectomy in the southern united states
Contraception, 2021Co-Authors: Ashley L White, Deborah L Billings, Emily S Mann, Payal P ShahAbstract:Abstract Objectives Clinical literature and contraception information guides use the terms “male sterilization” and “Vasectomy” interchangeably. We investigate the meanings men attach to “sterilization” and how those meanings compare to perceptions of “Vasectomy.” Study design Cisgender, heterosexual men, ages 25 to 67, living across seven U.S. southern states participated in individual telephone interviews from May to December 2019. Interviews explored men's experiences with contraception, including their perception of the term “sterilization.” We audio-recorded and transcribed the interviews and conducted thematic analyses using an inductive approach. Results While most participants described “Vasectomy” as a relatively benign procedure, they described “sterilization” as “sinister,” “bleak,” and “barbaric.” Participants’ discussions of sterilization invoked associations with eugenicist practices and specific historical examples of forced sterilization. While some participants recognized that Vasectomy is a means of achieving sterilization, most viewed the term “sterilization” as incongruous with the modern medical procedure of “Vasectomy,” precisely because sterilization has been used as a form of reproductive oppression. Conclusion Our findings suggest that men have strong affective responses to the term “sterilization.” Participants’ knowledge of historical eugenicist practices has implications for the acceptability of Vasectomy as a permanent contraceptive option in our contemporary context. Implications The phrase “male sterilization” can be associated with eugenics and coercive reproductive practices. Using the term for reproductive counselling, education, or research purposes may have implications for the acceptability of Vasectomy as a permanent contraceptive option.
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men s Vasectomy knowledge attitudes and information seeking behaviors in the southern united states results from an exploratory survey
American Journal of Men's Health, 2020Co-Authors: Ashley L White, Rachel E Davis, Deborah L Billings, Emily S MannAbstract:Vasectomy is one of the few options men have to manage their reproductive capacity and take on a more equitable role in pregnancy prevention. While the method is underused throughout the United States, the southern states have a lower prevalence rate compared to the rest of the country. Existing survey research does not assess what men know or think about the procedure as a means of understanding why this is the case. We created and conducted an exploratory survey to assess men's knowledge, attitudes, and information-seeking behaviors about Vasectomy in the Southern United States. We used targeted Facebook advertising to recruit men ages 25-70 years living in 7 southern states to complete an online survey (n = 397). Using regression analyses, we identify that participants who had a Vasectomy knew more about the procedure than participants who had not. Participants who had not had a Vasectomy had less positive attitudes about the procedure across all six attitude subscales compared to participants with vasectomies. We highlight potential avenues for future research to understand why this may be the case. Finally, the majority of participants knew someone who had had a Vasectomy. This suggests that men disclose having a Vasectomy to others. The interpersonal dynamics around Vasectomy decision-making and disclosure remain unknown and a viable area for future research. Findings from this exploratory survey may be used by public health officials interested in implementing campaigns to increase knowledge about Vasectomy and reduce stigma, which may encourage more positive attitudes about the procedure.
Keith Jarvi - One of the best experts on this subject based on the ideXlab platform.
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Vasectomy and risk of prostate cancer population based matched cohort study
BMJ, 2016Co-Authors: Madhur Nayan, Keith Jarvi, Craig C Earle, Robert J Hamilton, Erin M Macdonald, Muhammad Mamdani, Girish S Kulkarni, David N JuurlinkAbstract:Objective To determine the association between Vasectomy and prostate cancer, adjusting for measures of health seeking behaviour. Design Population based matched cohort study. Setting Multiple validated healthcare databases in Ontario, Canada, 1994-2012. Participants 326 607 men aged 20 to 65 who had undergone Vasectomy were identified through physician billing codes and matched 1:1 on age (within two years), year of cohort entry, comorbidity score, and geographical region to men who did not undergo a Vasectomy. Main outcomes measures The primary outcome was incident prostate cancer. Secondary outcomes were prostate cancer related grade, stage, and mortality. Results 3462 incident cases of prostate cancer were identified after a median follow-up of 10.9 years: 1843 (53.2%) in the Vasectomy group and 1619 (46.8%) in the non-Vasectomy group. In unadjusted analysis, Vasectomy was associated with a slightly increased risk of incident prostate cancer (hazard ratio 1.13, 95% confidence interval 1.05 to 1.20). After adjustment for measures of health seeking behaviour, however, no association remained (adjusted hazard ratio 1.02, 95% confidence interval 0.95 to 1.09). Moreover, no association was found between Vasectomy and high grade prostate cancer (adjusted odds ratio 1.05, 95% confidence interval 0.67 to 1.66), advanced stage prostate cancer (adjusted odds ratio 1.04, 0.81 to 1.34), or mortality (adjusted hazard ratio 1.06, 0.60 to 1.85). Conclusion The findings do not support an independent association between Vasectomy and prostate cancer.
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Vasectomy reversal provides long term pain relief for men with the post Vasectomy pain syndrome
The Journal of Urology, 2011Co-Authors: David Horovitz, Vehniah K Tjong, Trustin Domes, Ethan D Grober, Keith JarviAbstract:Purpose: The post-Vasectomy pain syndrome is a rare but serious and debilitating complication of Vasectomy. For men with the post-Vasectomy pain syndrome Vasectomy reversal is a surgical option after medical management has failed. However, there is a paucity of data in the literature defining its therapeutic efficacy. In this study we better define the role and effect of Vasectomy reversal in the treatment of men with the post-Vasectomy pain syndrome.Materials and Methods: Three urologists in Toronto, Ontario performed 149 publically funded Vasectomy reversals between January 2000 and September 2010. The electronic health records were reviewed and 23 of the 149 (15%) procedures were performed for the post-Vasectomy pain syndrome. Of these men who underwent 14 vasovasostomies 13 completed a telephone conducted questionnaire (response rate 56%). Patient demographics, preoperative and postoperative pain scores, and quality of life were retrospectively assessed.Results: Orchialgia occurred a mean ± SD of 19 ±...
Eugene F Fuchs - One of the best experts on this subject based on the ideXlab platform.
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reconsidering Vasectomy reversal over assisted reproduction in older couples
Fertility and Sterility, 2018Co-Authors: Akash Kapadia, Eugene F Fuchs, Jason C Hedges, Marcus Anthony, Ann Martinez Acevedo, Kevin OstrowskiAbstract:Objective To provide pregnancy and live birth rates from a contemporary series of Vasectomy reversals in men with female partners aged ≥35 years and to correlate the results with IVF. Setting Tertiary academic referral center. Design Retrospective comparative study of prospectively collected database. Patient(s) Two hundred forty-six men who underwent Vasectomy reversal for fertility with female partner aged ≥35 years. Intervention(s) Vasovasostomy or vasoepididymostomy. Main Outcome Measure(s) Correlation of pregnancy and live birth rate of this cohort by age groups with most recently published pregnancy and live birth rate per IVF cycle. Result(s) One hundred thirty-six men who underwent Vasectomy reversal between 2006 and 2014 met our inclusion criteria. Overall pregnancy and live birth rates were 35% and 30%, respectively. Subgroup analysis by female age groups (35–37, 38–40, >40 years) demonstrated pregnancy and live birth rates comparable to those per IVF cycle by age groups according to a recently published (2015) national report. Conclusion(s) Vasectomy reversal should be strongly considered in men with a partner aged ≤40 years. Additionally, Vasectomy reversal can be considered in carefully selected patients even with a partner aged >40 years.
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higher outcomes of Vasectomy reversal in men with the same female partner as before Vasectomy
The Journal of Urology, 2015Co-Authors: Kevin Ostrowski, Scott A Polackwich, Joe Kent, Michael J Conlin, Jason C Hedges, Eugene F FuchsAbstract:Purpose: We reviewed fertility outcomes of Vasectomy reversal at a high surgical volume center in men with the same female partner as before Vasectomy.Materials and Methods: We retrospectively studied a prospective database. All Vasectomy reversals were performed by a single surgeon (EFF). Patients who underwent microsurgical Vasectomy reversal and had the same female partner as before Vasectomy were identified from 1978 to 2011. Pregnancy and live birth rates, procedure type (bilateral vasovasostomy, bilateral vasoepididymostomy, unilateral vasovasostomy or unilateral vasoepididymostomy), patency rate, time from reversal and spouse age were evaluated.Results: We reviewed the records of 3,135 consecutive microsurgical Vasectomy reversals. Of these patients 524 (17%) who underwent Vasectomy reversal had the same female partner as before Vasectomy. Complete information was available on 258 patients (49%), who had a 94% vas patency rate. The clinical pregnancy rate was 83% by natural means compared to 60% in...
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relating economic conditions to Vasectomy and Vasectomy reversal frequencies a multi institutional study
The Journal of Urology, 2014Co-Authors: Vidit Sharma, Marc Goldstein, Eugene F Fuchs, Scott A Polackwich, Jason C Hedges, Jay I Sandlow, Kunj R Sheth, Sherwin Zargaroff, James M Dupree, Robert E BranniganAbstract:Purpose: It was theorized that the use of permanent contraceptive methods may vary with economic conditions. We evaluated the relationship between Vasectomy/Vasectomy reversal frequencies at several large referral centers and national economic indicators during 2 recessions spanning 2001 to 2011.Materials and Methods: We performed an institutional review board approved, retrospective chart review to identify the number of vasectomies/Vasectomy reversals per month at several large referral centers from January 2001 to July 2011. The rates of these procedures were pooled, correlated with national economic data and analyzed in a multivariate linear regression model.Results: A total of 4,599 vasectomies and 1,549 Vasectomy reversals were performed at our institutions during the study period. The number of vasectomies per month positively correlated with the unemployment rate (r = 0.556, p <0.001) and personal income per capita (r = 0.276, p = 0.002). The number of reversals per month negatively correlated wit...
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Vasectomy reversal performed 15 years or more after Vasectomy correlation of pregnancy outcome with partner age and with pregnancy results of in vitro fertilization with intracytoplasmic sperm injection
Fertility and Sterility, 2002Co-Authors: Eugene F Fuchs, Richard A BurtAbstract:Abstract Objective: To document a contemporary series of Vasectomy reversals performed in men 15 years or more after Vasectomy and to correlate the results with spousal age and results of ICSI for obstructive azoospermia. Setting: University referral center for male infertility. Design: Retrospective analysis of a single surgeon's experience compared with reported ICSI results. Participant(s): One hundred seventy-three men who had Vasectomy reversal 15 years or more after Vasectomy. Intervention(s): Reversal of Vasectomy by vasovasostomy or epididymovasostomy. Main Outcome Measure(s): Correlation of pregnancy results after Vasectomy reversal with spousal age and published ICSI results. Result(s): Pregnancy rates for the intervals of 15–19 years, 20–25 years, and >25 years after Vasectomy were 49%, 39%, and 25%, respectively. For spousal age 40 years, pregnancy rates were 64%, 49%, 32%, and 28%, respectively. The overall pregnancy rate was 43%, which is similar to the pregnancy rate of 40% for ICSI in obstructive azoospermia. Sixty-two percent of the men required a unilateral or bilateral epididymovasostomy. Conclusion(s): Spousal age is an important predictive factor after Vasectomy reversal among men who have reversal 15 years or more after Vasectomy. Pregnancy rates after Vasectomy reversal compare favorably with those obtained with ICSI.
Mads Melbye - One of the best experts on this subject based on the ideXlab platform.
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Vasectomy and prostate cancer risk a 38 year nationwide cohort study
Journal of the National Cancer Institute, 2019Co-Authors: Anders Husby, Jan Wohlfahrt, Mads MelbyeAbstract:Background A man's risk of prostate cancer has been linked to his prior reproductive history, with low sperm quality, low ejaculation frequency, and a low number of offspring being associated with increased prostate cancer risk. It is, however, highly controversial whether Vasectomy, a common sterilization procedure for men, influences prostate cancer risk. Methods We established a cohort of all Danish men (born between 1937 and 1996) and linked information on Vasectomy, doctor visits, socioeconomic factors, and cancer from nationwide registries using unique personal identification numbers. Incidence risk ratios for prostate cancer by time since Vasectomy and age at Vasectomy during the follow-up were estimated using log-linear Poisson regression. Results Overall, 26 238 cases of prostate cancer occurred among 2 150 162 Danish men during 53.4 million person-years of follow-up. Overall, vasectomized men had an increased risk of prostate cancer compared with nonvasectomized men (relative risk = 1.15, 95% confidence interval = 1.10 to 1.20). The increased risk of prostate cancer following Vasectomy persisted for at least 30 years after the procedure and was observed regardless of age at Vasectomy and cancer stage at diagnosis. Adjustment for the number of visits to the doctor and socioeconomic factors did not explain the association. Conclusions Vasectomy is associated with a statistically significantly increased long-term risk of prostate cancer. The absolute increased risk following Vasectomy is nevertheless small, but our finding supports a relationship between reproductive factors and prostate cancer risk.
