Surgical practice patterns for male urinary incontinence: Analysis of case logs from certifying American urologists Journal Article

   

Authors:	Poon, S. A.; Silberstein, J. L.; Savage, C.; Maschino, A. C.; Lowrance, W. T.; Sandhu, J. S.
Article Title:	Surgical practice patterns for male urinary incontinence: Analysis of case logs from certifying American urologists
Abstract:	Purpose: Several options exist for the surgical correction of male stress urinary incontinence including periurethral bulking agents, artificial urinary sphincters and the recently introduced male urethral slings. We investigated contemporary trends in the use of these treatments. Materials and Methods: Annualized case log data for incontinence surgeries from certifying and recertifying urologists were obtained from the ABU (American Board of Urology), ranging from 2004 to 2010. Chi-square tests and logistic regression models were used to evaluate the association between surgeon characteristics (type of certification, annual volume, practice type and practice location) and the use of incontinence procedures. Results: Among the 2,036 nonpediatric case logs examined the number of incontinence treatments reported for certification has steadily increased over time from 1,936 to 3,366 treatments per year from 2004 to 2010 (p = 0.008). Nearly a fifth of urologists reported placing at least 1 sling. The proportion of endoscopic procedures decreased from 80% of all incontinence procedures in 2004 to 60% in 2010, but they remained the exclusive incontinence procedure performed by 49% of urologists. A urologist's increased use of endoscopic treatments was associated with a decreased likelihood of performing a sling procedure (OR 0.5, p <0.0005). Artificial urinary sphincter use remained stable, accounting for 12% of procedures. Conclusions: Incontinence procedures are on the rise. Urethral slings have been widely adopted and account for the largest increase among treatment modalities. Endoscopic treatments continue to be commonly performed and may represent overuse in the face of improved techniques. Further research is required to validate these trends. © 2012 American Urological Association Education and Research, Inc.
Keywords:	adult; middle aged; surgical technique; retrospective studies; major clinical study; united states; physician's practice patterns; postoperative complication; physicians; prostatectomy; urology; endoscopic therapy; certification; urinary incontinence; urologic surgical procedures, male; urinary sphincter; artificial; bladder sphincter prosthesis; stress incontinence; suburethral sling; urinary sphincter, artificial; bulking agent; urologist; suburethral slings; recertification
Journal Title:	Journal of Urology
Volume:	188
Issue:	1
ISSN:	0022-5347
Publisher:	Elsevier Science, Inc.
Date Published:	2012-07-01
Start Page:	205
End Page:	210
Language:	English
DOI:	10.1016/j.juro.2012.03.012
PROVIDER:	scopus
PUBMED:	22591970
PMCID:	PMC3401485
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84862124282&partnerID=40&md5=9cdc7700af05c64aaf72ef742112bf50
Notes:	--- - "Export Date: 2 July 2012" - "CODEN: JOURA" - "Source: Scopus"

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