Volume 42, Issue 7 pp. 1563-1568
CLINICAL ARTICLE

US patterns of care for urodynamic evaluation for BPH

Christina Sze

Corresponding Author

Christina Sze

Department of Urology, New York-Presbyterian/Weill Cornell Medical Center, New York, New York, USA

Correspondence Christina Sze, Department of Urology, Weill Cornell Medical College, 525 East 68th St, Starr 900, New York, NY 10065, USA.

Email: [email protected]

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Tenny R. Zhang

Tenny R. Zhang

Department of Urology, New York-Presbyterian/Weill Cornell Medical Center, New York, New York, USA

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Leo Dreyfuss

Leo Dreyfuss

Department of Urology, New York-Presbyterian/Weill Cornell Medical Center, New York, New York, USA

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Gina DeMeo

Gina DeMeo

Department of Medical Eduation, Touro University California College of Osteopathic Medicine, Vallejo, California, USA

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Samantha L. Thorogood

Samantha L. Thorogood

Department of Urology, New York-Presbyterian/Weill Cornell Medical Center, New York, New York, USA

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Bilal Chughtai

Bilal Chughtai

Department of Urology, New York-Presbyterian/Weill Cornell Medical Center, New York, New York, USA

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Alexis E. Te

Alexis E. Te

Department of Urology, New York-Presbyterian/Weill Cornell Medical Center, New York, New York, USA

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Richard K. Lee

Richard K. Lee

Department of Urology, New York-Presbyterian/Weill Cornell Medical Center, New York, New York, USA

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Jim C. Hu

Jim C. Hu

Department of Urology, New York-Presbyterian/Weill Cornell Medical Center, New York, New York, USA

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First published: 03 July 2023

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.

CONFLICT OF INTEREST STATEMENT

Jim C. Hu receives research support from the Frederick J. and Theresa Dow Wallace Fund of the New York Community Trust. Jim C. Hu also receives salary support from NIH R01 CA241758, NIH R01CA259173, R01 CA273031, Prostate Cancer Foundation, PCORI CER-2019C1-15682, and CER-2019C2-17372. Bilal Chughtai is a consultant for Boston Scientific and Olympus. Alexis Te is consultant for Procept. The remaining authors report no further disclosures related to this work. No funding provided for manuscript development.

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

The full text of this article hosted at iucr.org is unavailable due to technical difficulties.