You have accessJournal of UrologyCME1 May 2022MP46-08 COST AND UTILIZATION OF CONCURRENT VS STAGED TESTICULAR IMPLANT FOR RADICAL ORCHIECTOMY Arman Walia, Joshua Horns, Niraj Paudel, Aditya Bagrodia, Jim Hotaling, and Tung-Chin Hsieh Arman WaliaArman Walia More articles by this author , Joshua HornsJoshua Horns More articles by this author , Niraj PaudelNiraj Paudel More articles by this author , Aditya BagrodiaAditya Bagrodia More articles by this author , Jim HotalingJim Hotaling More articles by this author , and Tung-Chin HsiehTung-Chin Hsieh More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002612.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: American Urological Association guidelines recommend testicular prosthesis discussion prior to orchiectomy. Utilization may be low. We investigated outcomes and care utilization between concurrent implant (CI) and staged implant (SI) insertion after radical orchiectomy. METHODS: The MarketScan Commercial claims database (2008-2017) was queried for men >18-years-old who underwent radical orchiectomy for testicular tumor, stratified as orchiectomy with no implant, CI, or SI (any time post-orchiectomy). 90-day outcomes included rate of reoperation, readmission, emergency department (ED) presentation, and outpatient visits. Regression models provided rate ratio comparison. RESULTS: 8803 (8564 no implant, 190 CI, 49 SI) patients were identified with no difference in age, Charlson comorbidity index, benefit plan, additional cancer treatment, or metastasis. Median perioperative cost at orchiectomy (+/- implant) for no implant, CI, and SI were $5682 (3648-8554), $7823 (5403-10973), and $5380 (4130-10521), respectively (p<0.001). Median perioperative cost for SI at implantation was $8180 (4920-14591) for a total cost (orchiectomy + implant) of $13560 (5380 + 8180). Total postoperative costs stratified by additional cancer treatment (chemotherapy, radiation, retroperitoneal surgery) are in Table 1. 90-day care utilization is in Table 2. CI patients were more likely to have follow-up (OR 2.48, p=0.006) with more visits (OR 1.54, p=0.030) compared to the SI group post-implantation, but had similar follow-up (OR 1.93, p=0.065) and less visits (OR 1.29, p=0.025) compared to the SI patients’ post-orchiectomy period. No difference in cost or rate of ED visits, readmission, or reoperation was identified.Overall explant rates were 4.7% (9) for CI and 14.3% (7) for SI (p=0.04) with a median time to explant of 166 (135-210) and 40 (9.5-141.5) days, respectively (p=0.06). Median cost of removal was $2060 (IQR 967-2880). CONCLUSIONS: CI placement has less total perioperative cost, lower explant rate, and similar postoperative utilization compared to SI. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e775 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Arman Walia More articles by this author Joshua Horns More articles by this author Niraj Paudel More articles by this author Aditya Bagrodia More articles by this author Jim Hotaling More articles by this author Tung-Chin Hsieh More articles by this author Expand All Advertisement PDF DownloadLoading ...