Recent Trends in Transurethral Surgeries and Urological Outpatient Procedures: a Nationwide Population-based Cohort Study

Abstract

Background Demographic change and advances in technology affect transurethral surgery and outpatient procedures in the urologic field. There are few population-based studies that accurately assess the trend of transurethral surgery and outpatient procedures including diagnostic tests. We investigated the recent epidemiologic trends in transurethral surgeries and urological outpatient procedures from 2009 to 2016 in Korea using the entire population-based cohort. Methods We analyzed medical service claim data of transurethral surgery, urological outpatient procedures submitted by medical service providers from the Health Insurance Review and Assessment Service from 2009 to 2016. Results Transurethral ureter surgery increased by 134.9% from 14,635 in 2009 to 34,382 in 2016 (B = 2,698; R 2 = 0.98; P < 0.001). The transurethral bladder surgery increased by 65.5% from 12,482 in 2009 to 20,658 in 2016 (B = 1,149; R 2 = 0.97; P < 0.001). Over the 8-years period, there were not significant changes in transurethral prostate (B = 43; R 2 = 0.04; P = 0.617) and urethral surgery (B = −12; R 2 = 0.18; P = 0.289). The significantly increasing trends in cystoscopy (B = 5,260; R 2 = 0.95; P < 0.001) and uroflowmetry (B = 53,942; R 2 = 0.99; P < 0.001) were observed during the 8-year period. There was no difference in bladder catheterization during the 8-year period. Urodynamic study (UDS: B = −2,156; R 2 = 0.77; P = 0.003) and electrical stimulation treatment (EST: B = −1,034; R 2 = 0.87; P < 0.001) significantly decreased. Conclusion In Korea, transurethral ureter surgery and transurethral bladder surgery have been continuously increasing. Transurethral prostate surgery and transurethral urethral surgery remained constant with no increase or decrease. Cystoscopy and uroflowmetry continue to increase, while UDS and EST continue to decrease.

Prediction of the composition of urinary stones using deep learning

“…Many studies and applications for machine learning and DL are being conducted in urology fields such as urolithiasis, kidney cancer, bladder cancer, and prostate cancer [ 14 ]. For example, with the development of optical technology, endoscopic instruments, and lasers, transurethral endoscopic surgery for urolithiasis is rapidly increasing [ 5 6 ], and faster and more accurate decision-making is required for urologists regarding various treatment methods.…”

“…Urolithiasis is one of the most common diseases in Korea and Western countries, and it can be a serious medical problem for the working-age population [ 2 3 4 ]. With the development of optical technology and endoscopic instruments, transurethral endoscopic surgery through a natural orifice in the field of urology has been increasing rapidly in recent years [ 5 6 ]. Currently, it is possible to acquire high-quality images in real-time for urolithiasis or lesions during most urological endoscopic surgeries.…”

Prophylactic Antimicrobial Therapy and Antimicrobial Stewardship in Urologic Surgery

“…Ureteroscopic stone surgery is a rapidly increasing endoscopic surgery in Korea [11]. Post-operative infection is one of the most feared complications of URSL.…”

Ambulatory surgery for cancer patients: current controversies and concerns

“…Conversely, patients who were classified as American Society of Anesthesiology (ASA) 3-4, and patients undergoing bilateral mastectomies with operative times longer than 4 h and/ or estimated blood losses (EBL) more than 100 ml, were more likely to receive either unplanned reoperation, readmission or an emergency department visit within 7 days of mastectomy [17]. Likewise, transurethral bladder resection of bladder tumour (TURB) is a common ambulatory procedure [18]. In patients with a long history of recurrence and noninvasive low-grade tumour, repeated TURBs are needed for restaging or for intravesical therapy [19].…”