PD20-01 SURGICAL PRACTICE PATTERNS FOR ERECTILE DYSFUNCTION: ANALYSIS OF CASE LOGS FROM CERTIFYING AMERICAN UROLOGISTS

Abstract

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Surgical Therapy1 Apr 2014PD20-01 SURGICAL PRACTICE PATTERNS FOR ERECTILE DYSFUNCTION: ANALYSIS OF CASE LOGS FROM CERTIFYING AMERICAN UROLOGISTS Daniel T. Oberlin, Richard S. Matulewicz, Laurie Bachrach, Sarah C. Flury, and Robert E. Brannigan Daniel T. OberlinDaniel T. Oberlin More articles by this author , Richard S. MatulewiczRichard S. Matulewicz More articles by this author , Laurie BachrachLaurie Bachrach More articles by this author , Sarah C. FlurySarah C. Flury More articles by this author , and Robert E. BranniganRobert E. Brannigan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1691AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives The increase in medical treatment options for the treatment of erectile dysfunction (ED) has changed how urologists manage ED. We reviewed contemporary surgical trends in penile prosthesis implantations in the United States with emphasis on practice patterns, surgeon characteristics, and practice types. Methods Annualized case log data of penile prosthesis surgeries from certifying and recertifying urologists were obtained from the American Board of Urology from 2003 to 2012. CPT code 54400 was used to identify malleable prosthesis surgeries; 54401 and 54405 was used to identify inflatable prosthesis surgeries. Chi-square tests and logistic regression models were used to evaluate the association between surgeon characteristics and practice patterns. Results A total 6,615 urologists were included in the surgical cohort with a total of 9,558 penile prosthesis placed over this time period. Only 23.9% of urologists reported placing a penile prosthesis (1587 urologists). Of all urologists recording logs, 1.5% considered themselves to be specialists in andrology. These andrologists, however, were responsible for a disproportionate 10% of all prostheses implanted (OR=5.9, p<.0001). The proportion of inflatable penile prosthesis compared to malleable prosthesis was 10:1 with an overall stable ratio of inflatable: malleable implants over this nine-year period. The number of prosthesis surgeries logged was skewed toward the most experienced urologists performing more implants than both new urologists (OR=1.92, p<.0001) and urologists undergoing their first recertification (OR=1.1, p=.006). Conclusions Despite an increase in the use of pharmacologic and non-surgical methods to correct erectile dysfunction, surgical intervention remains an important modality of treatment. Among urologists in the United States, those specializing in andrology perform a disproportionate number of implants. Interestingly, less than a quarter of urologists recorded case logs reports for penile implants, and urology seniority was directly correlated to total penile prosthesis case volume. This may suggest that surgeon experience and sub-specialization are key driving forces in performing penile prosthesis surgery. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e611 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Daniel T. Oberlin More articles by this author Richard S. Matulewicz More articles by this author Laurie Bachrach More articles by this author Sarah C. Flury More articles by this author Robert E. Brannigan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...