PDF(Pubmed)
Abstract：
The Supreme Court ruling Dobbs v. Jackson Women\'s Health Organization (June 2022) overturned federal protection of abortion rights, resulting in significant impact on both male and female reproductive rights and health care delivery. We conducted a retrospective review of all patients who underwent vasectomy at a single academic institution between June 2021 and June 2023. Our objective was to compare the rates of childless and partnerless vasectomies 1 year before and after this ruling, as these men may be more susceptible to postprocedural regret. Of total, 631 men (median age = 39 years, range = 20-70) underwent vasectomy consultation. Total vasectomies pre- and post-Dobbs were 304 (48%) versus 327 (52%). Total childless and partnerless vasectomies pre- and post-Dobbs were 44 (42%) versus 61 (58%) and 43 (46%) versus 50 (54%). Vasectomy completion rate was slightly increased post-Dobbs (90% vs. 88%; p = .240). The post-Dobbs cohort had significantly less children (1.8 vs. 2.0; p = .031). Men in the post-Dobbs era were significantly more likely to be commercially insured (72% vs. 64%) and less likely to be uninsured (1% vs. 6%; p = .002). Men who underwent childless vasectomy were significantly more likely to be younger (36.4 vs. 39.8 years; p < .001). There was a significantly greater proportion of Hispanic and Black men in the partnerless cohort compared to the cohort with partners (24% vs. 19% and 9% vs. 2%; p = .002). In conclusion, patients should be counseled on the permanent nature of this procedure, underscoring need for effective and reversible male contraception.
摘要：
最高法院裁定多布斯诉杰克逊妇女卫生组织（2022年6月）推翻了联邦对堕胎权的保护，对男女生殖权利和保健服务产生重大影响。我们对2021年6月至2023年6月在单一学术机构接受输精管结扎术的所有患者进行了回顾性审查。我们的目标是比较这项裁决前后1年无子女和无伴侣输精管切除术的比率，因为这些人可能更容易受到程序后遗憾的影响。总计，631名男性（平均年龄=39岁，范围=20-70）接受输精管结扎术咨询。Dobbs前后的输精管切除术总数分别为304（48％）和327（52％）。Dobbs前后的无子女和无伴侣输精管切除术总数分别为44（42％）对61（58％）和43（46％）对50（54％）。输精管结扎率在Dobbs后略有增加（90％vs.88%；p=.240）。后Dobbs队列的儿童明显较少（1.8vs.2.0；p=.031）。后多布斯时代的男性更有可能获得商业保险(72%与64%)，不太可能没有保险(1%与6%；p=.002）。进行无子女输精管结扎术的男性更年轻（36.4vs.39.8年；p<.001）。与有伴侣的队列相比，无伴侣队列中西班牙裔和黑人男性的比例明显更高(24%vs.19%和9%vs.2%；p=.002）。总之,应就该程序的永久性为患者提供咨询，强调需要有效和可逆的男性避孕。
