The Decline of Inpatient Penile Prosthesis over the 10-Year Period, 2000–2010
AIMS:
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.
METHODS:
We analyzed
data from National Inpatient Sample.
Patients in NIS who underwent PP insertion between 2000 and 2010 were included.
MAIN OUTCOME MEASURES:
Our
main outcomes were the number of inpatient PP
procedures, type of prosthesis, patient demographics, comorbidities, hospital
characteristics, and immediate perioperative complications.
RESULTS:
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.
CONCLUSIONS:
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: http://goo.gl/VmGOEU
- 1 Department of Urology, University of California San Francisco, San Francisco, CA; Department of Urology King Abdul Aziz University Jeddah Saudi Arabia.
- 2 Department of Urology University of California San Francisco San Francisco CA USA.
- 3 Department of Epidemiology and Biostatistics University of California San Francisco San Francisco CA USA.
- 4 Department of Urology University of California at Davis Sacramento CA USA.
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