Hospital-Based Trends in Penile Prosthetic Surgery

Abstract

Introduction We examined national and regional trends in hospital-based penile prosthetic surgery and identified patient-specific factors predicting receipt of inflatable vs. semi-rigid penile prostheses. Aims To improve our understanding of the surgical treatment for erectile dysfunction (ED). Methods We utilized the Nationwide Inpatient Sample (NIS) from 1998 to 2010 in the United States and the California Office of Statewide Health Planning and Development (OSHPD) database from 1995 to 2010. Total number of penile implants performed and proportions of inflatable vs. semi-rigid prosthesis were examined. Multivariate analysis (MVA) was performed to identify factors associated with selection of inflatable vs. semi-rigid prostheses. Main Outcome Measures Primary outcome measure is the total number of hospital-based penile prosthetic surgeries performed in the United States over a 12-year period (1998–2010). Secondary outcome measures include proportion of inflatable and semi-rigid prosthesis implantations and factors influencing receipt of different prostheses. Results We identified 53,967 penile prosthetic surgeries in the NIS; annual number implanted decreased from 4,703 to 2,338. Inflatable prostheses incurred higher costs but had a similar length of stay (LOS). In MVA, Caucasian race, Peyronie's disease, and private insurance were independently associated with receipt of an inflatable prosthesis. We identified 7,054 penile prostheses in OSHPD; annual number implanted decreased from 760 to 318. The proportion of inflatable prostheses increased significantly from 78.4% to 88.4% between 2001 and 2010. Inflatable prostheses incurred higher costs but had similar median LOS. In MVA, Caucasians and men without spinal cord injury were more likely to receive inflatable prosthesis. Conclusion Hospital-based penile prosthetic surgery has decreased substantially both nationwide and in California. In the United States, Caucasian race, Peyronie's disease, and private insurance were independently associated with receipt of an inflatable penile prosthesis. California population data correlated with national trends and can be utilized to further study surgical management of ED.

Perioperative management of patients undergoing penile prosthesis surgery in the UK: A survey of current practice

“…This volume of operative numbers in the UK and many European countries is in contrast to that seen in practice in the USA and is likely related to the nature of andrological practice within the UK. 6,7 Few surgeons in the UK practice ‘pure’ andrology, and often surgeons will undertake general urology alongside andrological procedures. Furthermore, in many regions, limits are set on the number of penile implants that may be performed due to NHS funding restrictions, thereby further reducing the overall number of cases performed nationwide.…”

Safety and Efficacy of Inflatable Penile Prostheses for the Treatment of Erectile Dysfunction: Evidence to Date

“…Due to similar complication rates and lower costs associated with outpatient penile implants, national trends have showed decreasing rates of hospital-based IPP surgeries. [57][58][59][60] Theses studies show that by 2010, more than…”

Epidemiology regarding penile prosthetic surgery

“…51 Studies also show that Caucasian patients and those with private insurance were associated with a higher probability to be PP recipients. 52 Across the series analyzed in this review, five studies 25,29,39,42,44 reported race as one of the demographic variables. Of a total of 1902 patients who underwent PP surgery (Figure 1), 79.4% were Whites (n = 1511), 14.5% were African-Americans (n = 276), 3.4% were Hispanics (n = 65), and 2.7% were other races (n = 51).…”