Saturday, January 23, 2016

The Decline of Inpatient Penile Prosthesis over the 10-Year Period, 2000–2010

Our aims were to analyze national trends of penile prosthesis (PP) surgery and to examine patient and hospital characteristics, and perioperative complications in the inpatient setting.

We analyzed data from National Inpatient Sample. Patients in NIS who underwent PP insertion between 2000 and 2010 were included.

Our main outcomes were the number of inpatient PP procedures, type of prosthesis, patient demographics, comorbidities, hospital characteristics, and immediate perioperative complications.

There was a progressive and dramatic decline by nearly half in the number of both inflatable (IPP) and noninflatable (NIPP) inpatientinsertions performed from 2000 to 2010 (P = 0.0001). The overall rate of inpatient complications for PP insertion was 13.5%. Patients with three or more comorbidities were found to have a higher risk of complications than patients with no comorbidities (OR = 1.45, 95% CI = 1.18-1.78) (P = 0.0001). Surgeries performed in high-volume hospitals (10 or more PP cases per year) were associated with reduced risk of complications (OR = 0.6) (P < 0.0001). There was a dramatic decrease in inpatient setting for PP placement in high-volume hospitals (32% in 2000 compared with 6% in 2010; P < 0.0001), and when compared with lower volume hospitals. NIPP was more likely performed in younger patients and in community hospitals, and less likely in white patients. Medicaid health insurance was associated with much higher rate of NIPP insertion than other types of insurance.

The number of PP procedures performed in the inpatient setting declined between 2000 and 2010, likely reflecting a shift toward increasing outpatient procedures. Our data also suggest a better outcome for patients having the procedure done at a high-volume center in terms ofinpatient complications

Below:  Volume of inpatient PP in the United States from 2000 to 2010. IPP, inflatable penile prosthesis; NIPP, noninflatable penile prosthesis

Below:   Patient comorbidities of inpatient PP from 2000 to 2010. 0, no comorbidity; 1, one comorbidity; 2, two comorbidities; 3+, three or more comorbidities

Below:  Hospital volume of inpatient penile prosthesis from 2000 to 2010. 1, one case/year; 2–9, two to nine cases/year; 10+, 10 or more cases/year

Full article at:

  • Department of Urology, University of California San Francisco, San Francisco, CA; Department of Urology King Abdul Aziz University Jeddah Saudi Arabia.
  • Department of Urology University of California San Francisco San Francisco CA USA.
  • Department of Epidemiology and Biostatistics University of California San Francisco San Francisco CA USA.
  • Department of Urology University of California at Davis Sacramento CA USA.

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