The Rise of the luxury Brosectomy
“This guy’s possibility of even getting laid for the rest of his life is pretty low. Is this really a necessary procedure?” It’s not a question you’d expect to hear in the waiting room of a urology clinic, just moments before a man’s vasectomy. But then, this wasn’t a normal waiting room.
Jeb Lopez, 44, and his best friend Rob Ferretti, 36, had paid $3,250 for a ‘vasectomy party’ at Obsidian Men’s Health clinic. They’d taken the day off work, and now they were sitting in colour-coordinated dressing gowns, enjoying a big screen TV, snacks, and a tumbler of Glenfiddich whisky on ice that would be available even during the procedure. Afterwards, they would celebrate with steak, and then go home to upload their experience to YouTube.
Welcome to the world of the ‘brosectomy’.
“Bro, it was awesome”, Lopez says in the video, as he returns from the operating table. “I want to go back in there. It was awesome. I want to come back tomorrow. I want to hang out here.”
While Lopez may be the only man alive to have uttered those words in the aftermath of a vasectomy, the pair are not alone in deciding to go as a group and turn the procedure into a fun day out.
Speaking to the Wall Street Journal, urologist Paul Turek, who has clinics in California and San Francisco, said group trips are a growing trend. He described a recent group who arrived by limousine.
On his blog, Turek pointed to the health benefits of treating the procedure in this way, describing one group who “took fewer pain pills, felt better faster and returned to work earlier than the average, go-it-alone-out-on-the-plank, tube-tied patient”.
Though they are technically reversible, vasectomies should be considered permanent birth control for men and this can be a daunting prospect.
Shane Geib M.D, the urologist who operated on Lopez and Ferretti at his Obsidian Men’s Health clinic just outside of Washington D.C, told The Telegraph that men often view the procedure as a major one.
“One thing that Mark [Richman, co-founder of the clinic] and I realised is that if you get a 35 to 40-year-old guy, this is a big deal to him”, he explained. “If you brush over it and say ‘oh, suck it up, you’re being a wimp’, the guys don’t like that, they take real offence.
“Particularly compared with the age equivalent in women, most men aren’t really used to going to the doctor. Even if they don’t come in groups, a lot of guys will send one guy, kind of as a sacrificial lamb, to check out the office. ‘Is this a nice place? Do you like the doctors? How are the staff?’ Then that guy can report back.”
Geib acknowledges that the luxury experience provided at Obsidian remains unorthodox, and relies on the tightly managed nature of a boutique surgery, together with his own personality and the relationships he and Richman have developed with their patients. In other words, it’s not a model you could transpose to any old clinic.
Geib’s proposition sounds reasonable, but here’s the million dollar question: can we expect to see the trend spread to the UK?
“You could make a case for it, but I’m not convinced it would really take off”, says Dr Gareth James, a GP, vasectomy surgeon, and Audit Lead for the Association of Surgeons in Primary Care.
“There’s a chap called Professor Michel Labrecque over in Canada who gets the morning list of 20 patients all sat down and he goes through it all with all of them as a group, and then bing bang bong, he goes through them at a rate of knots. He’s literally in the room doing one while the other one’s being prepped.
“He says he gets very good feedback doing that, but when we’ve discussed it with patients they go ‘ooh no we don’t want to do it as a group, no, no, no’. So again, I don’t know whether there’s some British reserve there!” Having audited vasectomy procedures, Dr James has found the results you might expect: the take-up for private surgery in the UK being relatively low and the vast bulk of the procedures take place on the NHS.
“We know our patients incredibly well and it’s a two-way street”, he says. He and Richman are the only surgeons at Obsidian, partially because “it has to be somebody who doesn’t mind going the extra mile for patients, to go in at night or at the weekend and won’t mind being texted at weird times on the weekend. Most of the patients are incredibly respectful. We’ve never really had any problems.
“As far as alcohol for the procedure is concerned, first of all, no-one would ever drive home. We Uber them home if their spouse doesn’t come down. And of course, not everyone drinks, but certainly when you get a couple of guys together, having a couple of drinks is part of the ambience that they want.”
The average cost for having the procedure carried out privately was £342 in his audit, a far cry from the thousands of dollars required for a luxury spa day-style surgery in the USA, and in his own experience Brits don’t tend to see it as a procedure requiring a private clinic. “Out of the last thousand patients, I’ve probably done two privately”, he continues.
“It sounds quite a fun idea and I think it would be quite a good thing to get some blokes involved with their mates, but there’s not much call for it.”
In some areas of the UK, NHS Clinical Commissioning Groups have put forward vasectomies as low clinical priority, meaning they are not funded on the NHS. Perhaps in those areas, the private practice might begin to include luxury options?
Caroline Brock is General Manager of one such practice, Tollgate Clinic in North East Essex, who says it’s not anxiety about the procedure but the cost that keeps men away.
“In some areas of the UK, such as North East Essex, vasectomies are no longer available on the NHS. This has a big impact on whether men choose to have a vasectomy”, she explained. “Despite being one of the most reliable methods of contraception and one of the most cost effective long term, the evidence is that at £345 a self-pay procedure, it just isn’t affordable for many men and demand falls by about 50pc.”
There is, of course, a major difference between discussing the procedure’s take-up in affluent areas of Washington D.C and Beverley Hills, and ordinary towns, cities and rural areas in the UK. But the difference seems to extend beyond cost, too. There seems to be a culture in the UK of taking the whole thing a bit more seriously.
“The UK has seen many campaigns to increase Men’s Health Awareness and encourage them to visit their GP or take up an appropriate appointment. However, trying to incentivise men to have a vasectomy by offering men’s spa days or alcohol isn’t likely to catch on as the NHS sees vasectomy as an important, irreversible decision in a man’s life, a decision that should not be influenced by the wrong incentives that could affect the eligibility of their consent to the procedure”, Brock said.
Geib would likely point to an hour long consultation with each patient that takes place ahead of the surgery, in which he or Richman make entirely sure that the implications of the decision are fully understood, as evidence that his methods are sound.
He sees what he’s doing as part of a broader trend to try and demystify the procedure, which to his surprise, can still come with a stigma. “A much bigger trend compared to the bringing of friends is that lots of men or married couples have just decided not to have children at all”, he noted. “We get a lot of people from Washington D.C who come in and say that they heard that ‘you don’t judge us because we decided not to have children’.
“I never really understood what that meant but apparently other clinics and urology offices have made some off colour comments to these families. I had a couple last year I did and both are professionals, and they went to their urologist who made some really unusual, odd comments in trying to dissuade them from permanent birth control. I think the way Mark and I have looked at this is that as long as this is a person of sound mind who can give consent [then that’s fine].
“We obviously have a lengthy discussion about how it should be considered permanent and while yes there are ways to reverse it, I’ve probably had one or two in my 17 years of practicing that wanted to reverse their vasectomy. It’s quite uncommon. It’s all part of trying to demystify the process and make it a more pleasant experience.”Whether it’s down to British reserve or simply the fact it’s often available free on the NHS, it seems unlikely that men in the UK will join the ‘vasectomy party’ party anytime soon. But it’s safe to say most would agree that as long as families are able to make informed decisions, the move to demystify the procedure and discourage men from feeling wary of it can only be a good thing. Now, where’s that Glenfiddich?