Pd46-12 Surgeon Volume in Penile Prosthesis Implantation Correlates With Re-Operation Rates—national Medicare Analysis

You have accessJournal of UrologySexual Function/Dysfunction: Surgical Therapy I (PD46)1 May 2024PD46-12 SURGEON VOLUME IN PENILE PROSTHESIS IMPLANTATION CORRELATES WITH RE-OPERATION RATES—NATIONAL MEDICARE ANALYSIS Navid Leelani, Thiago Furtado, Juan Andino, Young Shin, Sirikan Rojanasarot, Ryoko Sato, Helen Bernie, Petar Bajic, Carolyn Salter, and Joshua Halpern Navid LeelaniNavid Leelani , Thiago FurtadoThiago Furtado , Juan AndinoJuan Andino , Young ShinYoung Shin , Sirikan RojanasarotSirikan Rojanasarot , Ryoko SatoRyoko Sato , Helen BernieHelen Bernie , Petar BajicPetar Bajic , Carolyn SalterCarolyn Salter , and Joshua HalpernJoshua Halpern View All Author Informationhttps://doi.org/10.1097/01.JU.0001008900.49567.2e.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The number of men undergoing penile prosthesis (PP) implantation is expected to rise with the aging population in the United States. Previous research has found that higher surgeon volume regionally is associated with lower re-operation rates. The impact of surgeon volume and patient factors on re-operative rates at the national level remains unknown. METHODS: We used the 100% Medicare Standard Analytical Files (SAF) to identify men aged 65 and older who received a PP (malleable and inflatable) between 2018 and 2021. In this retrospective claims analysis, the outcomes of interest were reoperation rates at 90 days and 1 year following initial implantation. Reoperation was defined as removal, repair, or removal and replacement of PP with or without infection. Covariates included PP implanter volume as well as sociodemographic and clinical characteristics of patients. The annual average PP volumesfor all surgeons who performed a PP procedure between 2018 to 2021 in this Medicare SAF were obtained from the Atlas All-Payor Claims dataset using National Provider Identifiers. Multivariable logistic regression was used to examine the association between the reoperation rates and identified covariates. RESULTS: 8,343 patients received PP implantation during the study period. 46% of men were between ages 65-69, 78.0% White, and 82.5% from urban areas.. Most men received an inflatable PP (8,017; 96.1%). The overall reoperation rate at 90-days was 2.30% and increased to 6.34% at 1-year follow-up. The 90-day and 1-year reoperation rates by the type of PP implantation were 2.3% and 6.4% for inflatable PP, and 2.1% and 5.8% for malleable PP, respectively. On average, implanters had 10 procedures annually from 2018 to 2021. Logistic regression highlighted that patient age and implanter volume were associated with increased reoperation rates. Implanter volume was associated with lower odds of reoperation at 1-year post-implant with re-operation reduced by 23% OR 0.77; 95% CI 0.60, 0.99 for the highest quartile implanters (volume >31), as compared to the lowest quartile (volume <6). CONCLUSIONS: Our study highlights the importance of surgeon case volume in reducing the risk of reoperation at 90 days and 1 year for patients undergoing penile prosthesis operation. Importantly, race and geography did not seem to impact outcomes. Source of Funding: No fundings to disclose © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e979 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Navid Leelani More articles by this author Thiago Furtado More articles by this author Juan Andino More articles by this author Young Shin More articles by this author Sirikan Rojanasarot More articles by this author Ryoko Sato More articles by this author Helen Bernie More articles by this author Petar Bajic More articles by this author Carolyn Salter More articles by this author Joshua Halpern More articles by this author Expand All Advertisement PDF downloadLoading ...