Practice Patterns of Post-radical Prostatectomy Incontinence Surgery in Ontario
CUA Online Library. Wallis C. 06/25/13; 31301; MP-05.14
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Abstract
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Purpose: Urinary incontinence is a significant complication following radical prostatectomy. Surgical management of post-prostatectomy incontinence includes artificial urinary sphincter and urethral sling insertion. We assessed practice patterns within the province of Ontario with respect to both radical prostatectomy and the resultant incontinence procedures.
Materials and Methods: We performed a population-based study of 25,346 men in Ontario, Canada who underwent radical prostatectomy between 1993 and 2006. Using hospital and cancer registry data, we identified patients who subsequently underwent an incontinence procedure. We characterized the rates of both radical prostatectomy and incontinence procedures across Ontario during the study interval. We then analyzed rates of incontinence procedures performed as compared with those expected given the radical prostatectomy case volume.
Results: 703 (2.8%) men underwent subsequent insertion of an AUS and a further 282 (1.1%) underwent a urethral sling procedure (985 total incontinence procedures, 3.9%) over the study interval. There procedures were performed at 48 different institutions; however, 56% of all procedures were performed at only 3 sites. The majority of hospitals performed significantly fewer incontinence procedures than expected give their radical prostatectomy case volume.
Conclusions: These data clearly show that a small number of academic institutions provide the majority of surgical care for men with incontinence following radical prostatectomy.
Materials and Methods: We performed a population-based study of 25,346 men in Ontario, Canada who underwent radical prostatectomy between 1993 and 2006. Using hospital and cancer registry data, we identified patients who subsequently underwent an incontinence procedure. We characterized the rates of both radical prostatectomy and incontinence procedures across Ontario during the study interval. We then analyzed rates of incontinence procedures performed as compared with those expected given the radical prostatectomy case volume.
Results: 703 (2.8%) men underwent subsequent insertion of an AUS and a further 282 (1.1%) underwent a urethral sling procedure (985 total incontinence procedures, 3.9%) over the study interval. There procedures were performed at 48 different institutions; however, 56% of all procedures were performed at only 3 sites. The majority of hospitals performed significantly fewer incontinence procedures than expected give their radical prostatectomy case volume.
Conclusions: These data clearly show that a small number of academic institutions provide the majority of surgical care for men with incontinence following radical prostatectomy.
Purpose: Urinary incontinence is a significant complication following radical prostatectomy. Surgical management of post-prostatectomy incontinence includes artificial urinary sphincter and urethral sling insertion. We assessed practice patterns within the province of Ontario with respect to both radical prostatectomy and the resultant incontinence procedures.
Materials and Methods: We performed a population-based study of 25,346 men in Ontario, Canada who underwent radical prostatectomy between 1993 and 2006. Using hospital and cancer registry data, we identified patients who subsequently underwent an incontinence procedure. We characterized the rates of both radical prostatectomy and incontinence procedures across Ontario during the study interval. We then analyzed rates of incontinence procedures performed as compared with those expected given the radical prostatectomy case volume.
Results: 703 (2.8%) men underwent subsequent insertion of an AUS and a further 282 (1.1%) underwent a urethral sling procedure (985 total incontinence procedures, 3.9%) over the study interval. There procedures were performed at 48 different institutions; however, 56% of all procedures were performed at only 3 sites. The majority of hospitals performed significantly fewer incontinence procedures than expected give their radical prostatectomy case volume.
Conclusions: These data clearly show that a small number of academic institutions provide the majority of surgical care for men with incontinence following radical prostatectomy.
Materials and Methods: We performed a population-based study of 25,346 men in Ontario, Canada who underwent radical prostatectomy between 1993 and 2006. Using hospital and cancer registry data, we identified patients who subsequently underwent an incontinence procedure. We characterized the rates of both radical prostatectomy and incontinence procedures across Ontario during the study interval. We then analyzed rates of incontinence procedures performed as compared with those expected given the radical prostatectomy case volume.
Results: 703 (2.8%) men underwent subsequent insertion of an AUS and a further 282 (1.1%) underwent a urethral sling procedure (985 total incontinence procedures, 3.9%) over the study interval. There procedures were performed at 48 different institutions; however, 56% of all procedures were performed at only 3 sites. The majority of hospitals performed significantly fewer incontinence procedures than expected give their radical prostatectomy case volume.
Conclusions: These data clearly show that a small number of academic institutions provide the majority of surgical care for men with incontinence following radical prostatectomy.
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