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

Amjad Alwaal, Catherine R. Harris, Ahmed A. Hussein, Thomas H. Sanford, Charles E. Mcculloch, Alan W Shindel, Benjamin N. Breyer

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Introduction: Across all specialties, economic pressure is driving increased utilization of outpatient surgery when feasible. 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) inpatient insertions 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 of inpatient complications.

Original languageEnglish (US)
Pages (from-to)280-286
Number of pages7
JournalSexual Medicine
Volume3
Issue number4
DOIs
StatePublished - Dec 1 2015

Fingerprint

Penile Prosthesis
Inpatients
High-Volume Hospitals
Comorbidity
Community Hospital
Medicaid
Health Insurance
Insurance
Ambulatory Surgical Procedures
Prostheses and Implants
Outpatients
Economics
Demography
Outcome Assessment (Health Care)
Pressure

Keywords

  • Complications
  • Erectile Dysfunction
  • Outpatient Surgery
  • Penile Prosthesis

ASJC Scopus subject areas

  • Behavioral Neuroscience
  • Reproductive Medicine
  • Dermatology
  • Urology

Cite this

Alwaal, A., Harris, C. R., Hussein, A. A., Sanford, T. H., Mcculloch, C. E., Shindel, A. W., & Breyer, B. N. (2015). The Decline of Inpatient Penile Prosthesis over the 10-Year Period, 2000-2010. Sexual Medicine, 3(4), 280-286. https://doi.org/10.1002/sm2.82

The Decline of Inpatient Penile Prosthesis over the 10-Year Period, 2000-2010. / Alwaal, Amjad; Harris, Catherine R.; Hussein, Ahmed A.; Sanford, Thomas H.; Mcculloch, Charles E.; Shindel, Alan W; Breyer, Benjamin N.

In: Sexual Medicine, Vol. 3, No. 4, 01.12.2015, p. 280-286.

Research output: Contribution to journalArticle

Alwaal, A, Harris, CR, Hussein, AA, Sanford, TH, Mcculloch, CE, Shindel, AW & Breyer, BN 2015, 'The Decline of Inpatient Penile Prosthesis over the 10-Year Period, 2000-2010', Sexual Medicine, vol. 3, no. 4, pp. 280-286. https://doi.org/10.1002/sm2.82
Alwaal A, Harris CR, Hussein AA, Sanford TH, Mcculloch CE, Shindel AW et al. The Decline of Inpatient Penile Prosthesis over the 10-Year Period, 2000-2010. Sexual Medicine. 2015 Dec 1;3(4):280-286. https://doi.org/10.1002/sm2.82
Alwaal, Amjad ; Harris, Catherine R. ; Hussein, Ahmed A. ; Sanford, Thomas H. ; Mcculloch, Charles E. ; Shindel, Alan W ; Breyer, Benjamin N. / The Decline of Inpatient Penile Prosthesis over the 10-Year Period, 2000-2010. In: Sexual Medicine. 2015 ; Vol. 3, No. 4. pp. 280-286.
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abstract = "Introduction: Across all specialties, economic pressure is driving increased utilization of outpatient surgery when feasible. 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) inpatient insertions 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 of inpatient complications.",
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