Trend in Volume of Urologic Prosthetic Surgery after Initiation of Prostate Cancer Survivorship Program

Abstract

After diagnosis of prostate cancer (PCa), >98% of patients will be alive after 5 years. After prostatectomy, anatomic restoration of continence and erectile function is a vital part of a comprehensive survivorship program. We sought to determine the trend in urologic prosthetic surgery case volume after the initiation of a cancer survivorship program (CSP). A prospectively collected single-surgeon database was queried. All cases of urologic prosthetic surgery after initiation of a CSP were reviewed for etiology and patient demographics. Cases were grouped by year, and the trend was analyzed by the coefficient of determination. From January 2011 through October 2016, 247 inflatable penile prostheses (IPP), 81 artificial urinary sphincters (AUS), and 29 male sling procedures were performed, for a combined case volume of 357. Etiology was PCa in 188 cases (85 IPP, 103 AUS/sling) and rectal cancer in 1 (AUS). Evaluation of annual case volume found the greatest rise within first 2 years, but with continued growth throughout study interval (Figure). Analysis of all completed calendar years noted a significant increase in total annual cases (R2 = 0.8, p = 0.016). Subsequent to initiation of a CSP, prosthetic cases specific to benign disease also noted a significant increase (R2 = 0.917, p = 0.003). After initiation of a CSP, prosthetic urology case volume increases substantially. The greatest rise is noted in the first 2 years, but continued growth is noted at 5 years. Institutions offering comprehensive CSP should be prepared to accommodate the volume of interest in academic restoration and budget resources accordingly.