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US patterns of care for urodynamic evaluation for BPH
Introduction Practice patterns around the use of urodynamic evaluation (UDS) for benign prostatic hyperplasia (BPH) surgery are largely undefined. As such, we investigated factors associated with the use of UDS for BPH. Methods We used American Board of Urology case log data from 2008 to 2020, to co...
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| Published in: | Neurourology and urodynamics 2023-09, Vol.42 (7), p.1563-1568 |
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| container_title | Neurourology and urodynamics |
| container_volume | 42 |
| creator | Sze, Christina Zhang, Tenny R. Dreyfuss, Leo DeMeo, Gina Thorogood, Samantha L. Chughtai, Bilal Te, Alexis E. Lee, Richard K. Hu, Jim C. |
| description | Introduction
Practice patterns around the use of urodynamic evaluation (UDS) for benign prostatic hyperplasia (BPH) surgery are largely undefined. As such, we investigated factors associated with the use of UDS for BPH.
Methods
We used American Board of Urology case log data from 2008 to 2020, to compare patient‐ and surgeon‐sided factors associated with UDS utilization and BPH surgeries. We performed logistic regression models to identify factors independently associated with UDS usage for BPH.
Results
Among urologists performing UDS, the majority (80%) self‐identified as general urologists and practiced in a private practice group (69%). Compared with urologists who performed no UDS, urologists who performed any UDS for BPH were more likely to be from the Mid‐Atlantic (20.3% vs. 10.6%, p 1 000 000 (34.7% vs. 28.5%, p |
| doi_str_mv | 10.1002/nau.25239 |
| format | article |
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Practice patterns around the use of urodynamic evaluation (UDS) for benign prostatic hyperplasia (BPH) surgery are largely undefined. As such, we investigated factors associated with the use of UDS for BPH.
Methods
We used American Board of Urology case log data from 2008 to 2020, to compare patient‐ and surgeon‐sided factors associated with UDS utilization and BPH surgeries. We performed logistic regression models to identify factors independently associated with UDS usage for BPH.
Results
Among urologists performing UDS, the majority (80%) self‐identified as general urologists and practiced in a private practice group (69%). Compared with urologists who performed no UDS, urologists who performed any UDS for BPH were more likely to be from the Mid‐Atlantic (20.3% vs. 10.6%, p < 0.01) and practice in regions with populations of >1 000 000 (34.7% vs. 28.5%, p < 0.01). Overall, UDS utilization declined over time (odds ratio [OR]: 0.95 year‐to‐year, 95% confidence interval [CI]: 0.91–0.99). In adjusted analyses, the odds of performing UDS was higher among male (OR: 2.19, 95% CI: 1.17–4.09), older (OR: 1.05, 95% CI: 1.03–1.06), and female pelvic medicine and reconstructive surgery subspecialty (OR: 3.23, 95% CI: 2.01–5.2) urologists. Additionally, performing UDS for BPH was associated with higher BPH surgical case volume (OR: 1.004, 95% CI: 1.001–1.008).
Conclusion
There is a significant practice variation in use of UDS for BPH. Although overall BPH surgeries are increasing, urologists are increasingly less likely to perform UDS for BPH. Specifically, urologists who perform UDS have significantly higher BPH case volume than those who do not perform UDS, suggesting that UDS usage may not factor into BPH surgery decision‐making.</description><identifier>ISSN: 0733-2467</identifier><identifier>EISSN: 1520-6777</identifier><identifier>DOI: 10.1002/nau.25239</identifier><identifier>PMID: 37395472</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>BPH ; Decision making ; Hyperplasia ; LUTS ; practice patterns ; Reconstructive surgery ; Regression analysis ; Surgery ; urodynamics ; Urology</subject><ispartof>Neurourology and urodynamics, 2023-09, Vol.42 (7), p.1563-1568</ispartof><rights>2023 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3139-71cc75915bb2d24b345d011bb9a0da11b3af68102f8183d0032a6e7fd799b6433</cites><orcidid>0000-0002-0515-2578 ; 0000-0002-9891-8906</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37395472$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sze, Christina</creatorcontrib><creatorcontrib>Zhang, Tenny R.</creatorcontrib><creatorcontrib>Dreyfuss, Leo</creatorcontrib><creatorcontrib>DeMeo, Gina</creatorcontrib><creatorcontrib>Thorogood, Samantha L.</creatorcontrib><creatorcontrib>Chughtai, Bilal</creatorcontrib><creatorcontrib>Te, Alexis E.</creatorcontrib><creatorcontrib>Lee, Richard K.</creatorcontrib><creatorcontrib>Hu, Jim C.</creatorcontrib><title>US patterns of care for urodynamic evaluation for BPH</title><title>Neurourology and urodynamics</title><addtitle>Neurourol Urodyn</addtitle><description>Introduction
Practice patterns around the use of urodynamic evaluation (UDS) for benign prostatic hyperplasia (BPH) surgery are largely undefined. As such, we investigated factors associated with the use of UDS for BPH.
Methods
We used American Board of Urology case log data from 2008 to 2020, to compare patient‐ and surgeon‐sided factors associated with UDS utilization and BPH surgeries. We performed logistic regression models to identify factors independently associated with UDS usage for BPH.
Results
Among urologists performing UDS, the majority (80%) self‐identified as general urologists and practiced in a private practice group (69%). Compared with urologists who performed no UDS, urologists who performed any UDS for BPH were more likely to be from the Mid‐Atlantic (20.3% vs. 10.6%, p < 0.01) and practice in regions with populations of >1 000 000 (34.7% vs. 28.5%, p < 0.01). Overall, UDS utilization declined over time (odds ratio [OR]: 0.95 year‐to‐year, 95% confidence interval [CI]: 0.91–0.99). In adjusted analyses, the odds of performing UDS was higher among male (OR: 2.19, 95% CI: 1.17–4.09), older (OR: 1.05, 95% CI: 1.03–1.06), and female pelvic medicine and reconstructive surgery subspecialty (OR: 3.23, 95% CI: 2.01–5.2) urologists. Additionally, performing UDS for BPH was associated with higher BPH surgical case volume (OR: 1.004, 95% CI: 1.001–1.008).
Conclusion
There is a significant practice variation in use of UDS for BPH. Although overall BPH surgeries are increasing, urologists are increasingly less likely to perform UDS for BPH. Specifically, urologists who perform UDS have significantly higher BPH case volume than those who do not perform UDS, suggesting that UDS usage may not factor into BPH surgery decision‐making.</description><subject>BPH</subject><subject>Decision making</subject><subject>Hyperplasia</subject><subject>LUTS</subject><subject>practice patterns</subject><subject>Reconstructive surgery</subject><subject>Regression analysis</subject><subject>Surgery</subject><subject>urodynamics</subject><subject>Urology</subject><issn>0733-2467</issn><issn>1520-6777</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp10EFLwzAUB_AgipvTg19ACl70UPeSNE1ynEOdMFTQnUPaptDRNjNplX174zo9CJ7yID_-vPdH6BzDDQYg01b3N4QRKg_QGDMCcco5P0Rj4JTGJEn5CJ14vwYAQRN5jEaUU8kSTsaIrV6jje4641of2TLKtTNRaV3UO1tsW91UeWQ-dN3rrrLt7uf2ZXGKjkpde3O2fydodX_3Nl_Ey-eHx_lsGecUUxlznOecScyyjBQkyWjCCsA4y6SGQoeB6jIVGEgpsKAFACU6NbwsuJRZmlA6QVdD7sbZ9974TjWVz01d69bY3isiKBEJERgHevmHrm3v2rBdUAzCuYKLoK4HlTvrvTOl2riq0W6rMKjvLlXoUu26DPZin9hnjSl-5U95AUwH8FnVZvt_knqarYbILyOHepk</recordid><startdate>202309</startdate><enddate>202309</enddate><creator>Sze, Christina</creator><creator>Zhang, Tenny R.</creator><creator>Dreyfuss, Leo</creator><creator>DeMeo, Gina</creator><creator>Thorogood, Samantha L.</creator><creator>Chughtai, Bilal</creator><creator>Te, Alexis E.</creator><creator>Lee, Richard K.</creator><creator>Hu, Jim C.</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0515-2578</orcidid><orcidid>https://orcid.org/0000-0002-9891-8906</orcidid></search><sort><creationdate>202309</creationdate><title>US patterns of care for urodynamic evaluation for BPH</title><author>Sze, Christina ; Zhang, Tenny R. ; Dreyfuss, Leo ; DeMeo, Gina ; Thorogood, Samantha L. ; Chughtai, Bilal ; Te, Alexis E. ; Lee, Richard K. ; Hu, Jim C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3139-71cc75915bb2d24b345d011bb9a0da11b3af68102f8183d0032a6e7fd799b6433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>BPH</topic><topic>Decision making</topic><topic>Hyperplasia</topic><topic>LUTS</topic><topic>practice patterns</topic><topic>Reconstructive surgery</topic><topic>Regression analysis</topic><topic>Surgery</topic><topic>urodynamics</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sze, Christina</creatorcontrib><creatorcontrib>Zhang, Tenny R.</creatorcontrib><creatorcontrib>Dreyfuss, Leo</creatorcontrib><creatorcontrib>DeMeo, Gina</creatorcontrib><creatorcontrib>Thorogood, Samantha L.</creatorcontrib><creatorcontrib>Chughtai, Bilal</creatorcontrib><creatorcontrib>Te, Alexis E.</creatorcontrib><creatorcontrib>Lee, Richard K.</creatorcontrib><creatorcontrib>Hu, Jim C.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Neurourology and urodynamics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sze, Christina</au><au>Zhang, Tenny R.</au><au>Dreyfuss, Leo</au><au>DeMeo, Gina</au><au>Thorogood, Samantha L.</au><au>Chughtai, Bilal</au><au>Te, Alexis E.</au><au>Lee, Richard K.</au><au>Hu, Jim C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>US patterns of care for urodynamic evaluation for BPH</atitle><jtitle>Neurourology and urodynamics</jtitle><addtitle>Neurourol Urodyn</addtitle><date>2023-09</date><risdate>2023</risdate><volume>42</volume><issue>7</issue><spage>1563</spage><epage>1568</epage><pages>1563-1568</pages><issn>0733-2467</issn><eissn>1520-6777</eissn><abstract>Introduction
Practice patterns around the use of urodynamic evaluation (UDS) for benign prostatic hyperplasia (BPH) surgery are largely undefined. As such, we investigated factors associated with the use of UDS for BPH.
Methods
We used American Board of Urology case log data from 2008 to 2020, to compare patient‐ and surgeon‐sided factors associated with UDS utilization and BPH surgeries. We performed logistic regression models to identify factors independently associated with UDS usage for BPH.
Results
Among urologists performing UDS, the majority (80%) self‐identified as general urologists and practiced in a private practice group (69%). Compared with urologists who performed no UDS, urologists who performed any UDS for BPH were more likely to be from the Mid‐Atlantic (20.3% vs. 10.6%, p < 0.01) and practice in regions with populations of >1 000 000 (34.7% vs. 28.5%, p < 0.01). Overall, UDS utilization declined over time (odds ratio [OR]: 0.95 year‐to‐year, 95% confidence interval [CI]: 0.91–0.99). In adjusted analyses, the odds of performing UDS was higher among male (OR: 2.19, 95% CI: 1.17–4.09), older (OR: 1.05, 95% CI: 1.03–1.06), and female pelvic medicine and reconstructive surgery subspecialty (OR: 3.23, 95% CI: 2.01–5.2) urologists. Additionally, performing UDS for BPH was associated with higher BPH surgical case volume (OR: 1.004, 95% CI: 1.001–1.008).
Conclusion
There is a significant practice variation in use of UDS for BPH. Although overall BPH surgeries are increasing, urologists are increasingly less likely to perform UDS for BPH. Specifically, urologists who perform UDS have significantly higher BPH case volume than those who do not perform UDS, suggesting that UDS usage may not factor into BPH surgery decision‐making.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>37395472</pmid><doi>10.1002/nau.25239</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-0515-2578</orcidid><orcidid>https://orcid.org/0000-0002-9891-8906</orcidid></addata></record> |
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| subjects | BPH Decision making Hyperplasia LUTS practice patterns Reconstructive surgery Regression analysis Surgery urodynamics Urology |
| title | US patterns of care for urodynamic evaluation for BPH |
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