March Madness drives surge in vasectomies thanks to strategic marketing
AUSTIN (KXAN) -- March is one of the busiest seasons for vasectomies, and it's usually in the middle of the NCAA basketball tournament. Men who are seeking the procedure are not really college basketball fans.
"A few clinics realize that if they promoted - 'Hey, you're going to get a couple days to kind of lay low, and there's sports on all day long,' and I think everyone sort of followed suit," said Dr. Sarah Vij, an associate professor of surgery and urologist at the University of Texas Health Austin.
The story behind the nationwide surge of vasectomies comes down to marketing.
"In my experience, when guys come in March, I'll sort of say, 'Hey, are you here because you want to watch March Madness? And a lot of them say, 'No,'" the urologist said. "I think it's just the marketing reminds men that this is something they've been meaning to do. I think a lot of patients tend to kind of have it on their to-do list and keep kicking the can. So it just gets it front of mind and gets them in."
KXAN invited Dr. Vij to answer some questions on vasectomies, including why there's been an increase in younger men getting the procedure, who shouldn't get a vasectomy, and how effective reversals are.
Read an edited transcription of the conversation below.
What are the risks?
VIJ: The risks of a vasectomy are really mostly sort of short-term risks. So things like bleeding, skin infection and epididymitis, which is a little infection, or sometimes just inflammation. There is a small risk, probably 1%, of prolonged testicular pain, so that's obviously something we try to avoid, and we do have treatments for it. When that does happen, thankfully, it's rare.
Does having the procedure affect a man's sex drive?
VIJ: There is not an increased risk of sexual dysfunction. A lot of patients ask that, is it going to affect their erections or anything? And the answer is no, there's not an increased risk of prostate cancer.
How does it compare to tubal ligation in women?
VIJ: Because of where the fallopian tubes are in a woman, in the pelvis, the procedure does require entry into the abdomen, general anesthesia, so it is a higher risk that can be done at the time of a C-section.
A vasectomy is an office procedure with local anesthetic. It's very quick, generally, a few minutes per side, and the recovery is generally just a couple of days of laying low. You can walk around, but just nothing vigorous and spend some time icing well.
What is a rough estimate of how long the process could take?
VIJ: The patient arrives. They get checked in. They do the typical intake when you see a doctor. You get the patient into a gown, onto the table, and get them prepped, draped.
The procedure itself is less than 10 minutes, and then they'll check vital signs, make sure that they're feeling good after the procedure, get them dressed, so they may end up being in the office for 45 minutes to an hour, but the procedure itself is kind of a small percentage of that time.
Then they can drive themselves to and from, unless they elect to take an anxiety medicine to help calm their nerves. A small percentage of my patients will do that just to help them get through it. In that case, you need a driver. But for most patients, they're driving themselves in and out. There's not a lot of disruption to schedules.
There's been a rise of interest in vasectomies the past few years. What is the reason behind it?
VIJ: After Roe v. Wade was overturned, we saw a significant increase. Just anecdotally, we all felt like we were seeing more consults—younger patients, more childless patients. Several academic centers around the country looked at this. We published our experience when I was at the Cleveland Clinic, and it was a pretty substantial uptick in consultation.
Can you talk to me about men playing more of a role in reproductive care?
VIJ: When we talk about reproductive rights, reproductive care, everybody tends to think about women, and obviously, men play just as important a role. A vasectomy is really the main way that a man can take full control in preventing a pregnancy, right? I mean, there are condoms, but most birth control really falls to the female.
I think the fact that that more and more men are coming in for this procedure, again, whether it's politically related or not, I think speaks to the fact that that there's more awareness that men play a part, and that men can take some control if they don't want to have an unintended pregnancy. Fifty years ago, it was just really thought to be a woman's burden to bear. And I think that's changing.
How effective are reversals? And if a man decides to have one, can they get it six months post-vasectomy?
VIJ: Vasectomies are considered permanent sterilization. We do frame it to patients that way. They can be reversed. It's just that reversals tend not to be covered by insurance, so they're quite costly.
If a guy comes to me and says, 'Hey, I don't want kids now, but maybe in five years,' I wouldn't advise a vasectomy, but life circumstances change and people do change their minds.
Reversals do have a high success rate, particularly when performed within 15 years of the vasectomy, which is the great majority of men coming in. You had mentioned six months. Yes, we can do reversals six months post-vasectomy, and the success rate is 95%. Again, the insurance coverage, not great.
It is a general anesthetic, a more involved procedure than the vasectomy itself, but we do have nice success rates with reversals, if a patient does change their mind.
Does insurance cover vasectomies?
VIJ: Vasectomy is generally covered by insurance. The only exceptions I'm aware of to that would be a religious employer that has a religious objection, so some Catholic employers will not cover it, but otherwise you're going to pay just the co pay for the consultation, for that initial visit, and then you may have a co pay for the procedure, and that depends on your insurance and your deductibles.
How long should a man wait before having sex after having the procedure?
VIJ: We advise contraception after the procedure, and the reason for that is we cut in the scrotum, or the sac, and there's still sperm downstream, kind of hanging out in the tubes. We definitely advise contraception until they get the post-op semen tests, which can be done as soon as eight weeks.
Every urologist is a little bit different. I typically recommend three months, just to try to reduce the chance that the patient will have to repeat it. So anywhere in that two to four-month range, they'll get the semen test and until they hear from the doctor's office that everything looks good, then they're safe to stop using contraception.
That's another thing that I tell patients to factor in. Maybe their partner is getting an IUD out. You want to make sure that you don't have a period where you don't have an option for contraception.
A lot of the 'oops pregnancies' you hear about after vasectomies are in patients who didn't follow those instructions or never got their post op semen test, so they never got that confirmation. 'Hey, yes, this was a success.' That's a really key piece of it.