An Analysis of the Procedure Volume and Geographic Distribution of US Urologists Performing Outpatient-Based Inflatable Penile Prosthesis Implantation

Abstract

Introduction: This study described the procedure volume and geographic distribution of US urologists performing outpatient-based inflatable penile prosthesis (IPP) implantation. Methods: This retrospective administrative claims analysis from Definitive Healthcare identified urologists performing outpatient IPP implantation (Current Procedural Terminology 54405) on commercially insured or Medicare patients in 2021 in hospital outpatient settings. Procedural volumes for each implanter were calculated, and geographical analyses used their primary affiliated hospitals to identify the states in which the procedures were performed. Results: In 2021, 2049 urologists conducted 21,835 outpatient-based IPP procedures on a representative sample of commercially insured and Medicare patients, averaging 10.7 procedures per implanter annually. Procedural volumes were right-skewed: 8.6% of urologists performed 33.7% of procedures. Most urologists (91.4%) performed <20 cases. The highest volume implanters who performed more than 100 cases accounted for 6.3% of procedure volumes. Geographical analysis showed Florida (11.2%), California (7.8%), Texas (7.5%), New York (5.9%), Michigan (4.2%), Ohio (3.9%), and Georgia (3.9%) had the highest numbers of outpatient implanters, consistent with the top 7 states by IPP implantation volume (Florida [11.4%], Texas [9.4%], New York [6.5%], California [6.3%], Ohio [5.8%], Georgia [4.2%], and Michigan [3.4%]). Conclusions: Most urologists performing outpatient IPP (91.4%) performed <20 procedures per year in 2021. Less than 10% performed approximately one-third of the procedures. These findings highlight essential considerations for fostering development in the field of urology, particularly for emerging implanters aiming to expand patient outreach. The implications aim to establish a balanced and accessible landscape, benefiting both practitioners and the patients they serve.