Increasing Use of Sacral Neuromodulation Procedures in Females Amongst Certifying American Urologists
CUA Online Library. Elterman D. 06/24/13; 31279; MP-04.07
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Abstract
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Introduction and Objective:
Refractory overactive bladder (OAB) syndrome remains a management challenge to urologists. When multiple medical therapies have failed, treatment options may include sacral neuromodulation (SNM) or surgery such as augmentation cystoplasty. We investigated the surgical practice patterns of American urologists performing procedures for refractory OAB in females over the last decade.
Materials and Methods:
Data on OAB procedures performed between 2003 and 2012 by certifying and recertifying urologists were obtained in the form of annualized case logs from the American Board of Urology (ABU). Associations between surgeon characteristics (type of certification, annual volume, practice type and location) and use of OAB procedures were evaluated.
Results:
Over the past decade 756 of 6,615 (11.4%) urologists certifying or recertifying with the ABU performed procedures for the treatment of refractory OAB. 45 of these surgeons (6%) completed fellowships in female urology and 72 surgeons (10%) completed another type of fellowship program. Recertifying surgeons performed 70% of all sacral neuromodulation (SNM) procedures. The total number of OAB procedures has consistently increased from 64 to 2086 between 2003–2012. That increase was driven by the increase in SNM cases: 48 to 2068 cases (years 2003–2012). Rates of enterocystoplasty have remained stable with 14 to 38 cases reported annually. However, they have declined relative to the total number of OAB procedures, from 25% of all captured OAB procedures in 2003 to <1% in 2012.
Conclusions:
The burden of refractory OAB has grown significantly over the past decade. While the use of enterocystoplasties has always been less common than SNM in the past decade, the use of SNM has nearly replaced the use of enterocystoplasties for all patients in recent years.
Refractory overactive bladder (OAB) syndrome remains a management challenge to urologists. When multiple medical therapies have failed, treatment options may include sacral neuromodulation (SNM) or surgery such as augmentation cystoplasty. We investigated the surgical practice patterns of American urologists performing procedures for refractory OAB in females over the last decade.
Materials and Methods:
Data on OAB procedures performed between 2003 and 2012 by certifying and recertifying urologists were obtained in the form of annualized case logs from the American Board of Urology (ABU). Associations between surgeon characteristics (type of certification, annual volume, practice type and location) and use of OAB procedures were evaluated.
Results:
Over the past decade 756 of 6,615 (11.4%) urologists certifying or recertifying with the ABU performed procedures for the treatment of refractory OAB. 45 of these surgeons (6%) completed fellowships in female urology and 72 surgeons (10%) completed another type of fellowship program. Recertifying surgeons performed 70% of all sacral neuromodulation (SNM) procedures. The total number of OAB procedures has consistently increased from 64 to 2086 between 2003–2012. That increase was driven by the increase in SNM cases: 48 to 2068 cases (years 2003–2012). Rates of enterocystoplasty have remained stable with 14 to 38 cases reported annually. However, they have declined relative to the total number of OAB procedures, from 25% of all captured OAB procedures in 2003 to <1% in 2012.
Conclusions:
The burden of refractory OAB has grown significantly over the past decade. While the use of enterocystoplasties has always been less common than SNM in the past decade, the use of SNM has nearly replaced the use of enterocystoplasties for all patients in recent years.
Introduction and Objective:
Refractory overactive bladder (OAB) syndrome remains a management challenge to urologists. When multiple medical therapies have failed, treatment options may include sacral neuromodulation (SNM) or surgery such as augmentation cystoplasty. We investigated the surgical practice patterns of American urologists performing procedures for refractory OAB in females over the last decade.
Materials and Methods:
Data on OAB procedures performed between 2003 and 2012 by certifying and recertifying urologists were obtained in the form of annualized case logs from the American Board of Urology (ABU). Associations between surgeon characteristics (type of certification, annual volume, practice type and location) and use of OAB procedures were evaluated.
Results:
Over the past decade 756 of 6,615 (11.4%) urologists certifying or recertifying with the ABU performed procedures for the treatment of refractory OAB. 45 of these surgeons (6%) completed fellowships in female urology and 72 surgeons (10%) completed another type of fellowship program. Recertifying surgeons performed 70% of all sacral neuromodulation (SNM) procedures. The total number of OAB procedures has consistently increased from 64 to 2086 between 2003–2012. That increase was driven by the increase in SNM cases: 48 to 2068 cases (years 2003–2012). Rates of enterocystoplasty have remained stable with 14 to 38 cases reported annually. However, they have declined relative to the total number of OAB procedures, from 25% of all captured OAB procedures in 2003 to <1% in 2012.
Conclusions:
The burden of refractory OAB has grown significantly over the past decade. While the use of enterocystoplasties has always been less common than SNM in the past decade, the use of SNM has nearly replaced the use of enterocystoplasties for all patients in recent years.
Refractory overactive bladder (OAB) syndrome remains a management challenge to urologists. When multiple medical therapies have failed, treatment options may include sacral neuromodulation (SNM) or surgery such as augmentation cystoplasty. We investigated the surgical practice patterns of American urologists performing procedures for refractory OAB in females over the last decade.
Materials and Methods:
Data on OAB procedures performed between 2003 and 2012 by certifying and recertifying urologists were obtained in the form of annualized case logs from the American Board of Urology (ABU). Associations between surgeon characteristics (type of certification, annual volume, practice type and location) and use of OAB procedures were evaluated.
Results:
Over the past decade 756 of 6,615 (11.4%) urologists certifying or recertifying with the ABU performed procedures for the treatment of refractory OAB. 45 of these surgeons (6%) completed fellowships in female urology and 72 surgeons (10%) completed another type of fellowship program. Recertifying surgeons performed 70% of all sacral neuromodulation (SNM) procedures. The total number of OAB procedures has consistently increased from 64 to 2086 between 2003–2012. That increase was driven by the increase in SNM cases: 48 to 2068 cases (years 2003–2012). Rates of enterocystoplasty have remained stable with 14 to 38 cases reported annually. However, they have declined relative to the total number of OAB procedures, from 25% of all captured OAB procedures in 2003 to <1% in 2012.
Conclusions:
The burden of refractory OAB has grown significantly over the past decade. While the use of enterocystoplasties has always been less common than SNM in the past decade, the use of SNM has nearly replaced the use of enterocystoplasties for all patients in recent years.
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