Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL.
Division of Biostatistics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
Urology. 2020 Sep;143:130-136. doi: 10.1016/j.urology.2020.04.016. Epub 2020 Apr 21.
To describe trends in the characteristics of urologic surgeons performing vasectomy over time.
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.
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]).
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.
描述随时间推移行输精管切除术的泌尿科医生特征的变化趋势。
我们对美国泌尿科委员会在 2004 年至 2013 年期间的病例记录进行了回顾性、横断面研究，检查了外科医生的特征。我们使用广义估计方程（log 链接和负二项分布），研究了随时间推移外科医生行输精管切除术数量的人口统计学差异（性别、农村地区和外科医生数量）。
在 2004 年至 2013 年期间，有 5316 名泌尿科医生的病例记录在 7 个月的认证窗口内。这些外科医生中，大多数自认为是普通泌尿科医生（82.8%），一小部分是男科和不育症专家（1.7%）。在所有年份中，研究期间每位认证外科医生的输精管切除术中位数为 14 例（四分位距 6-26）。大多数输精管切除术由高容量外科医生（≥26 例）进行，每年占 49.2%至 66.9%，而低容量（≤5 例）外科医生进行的比例每年占 3.3%至 6.6%。在整个研究期间，男性外科医生行输精管切除术的频率是女性外科医生的 2.20 倍（95%置信区间 1.93-2.49；P<0.0001），并且没有证据表明这种差距随时间变化（性别-年份交互作用 1.01[95%置信区间：0.97-1.06；p=0.576]）。
虽然进行输精管切除术的大多数泌尿科医生认为自己是普通泌尿科医生，但在少数高容量外科医生中似乎更关注输精管切除术实践。此外，虽然行输精管切除术的女性外科医生数量有所增加，但女性行输精管切除术的比例仍存在性别差距。
