Modern utilization of penile prosthesis surgery: a national claim registry analysis

Abstract

The objective of this study was to evaluate the modern utilization of penile prosthesis surgery based on data derived from national claim databases and contrast to an analysis of patients similarly treated at an academic center during a contemporaneous period. A retrospective claim analysis utilizing a national database (MarketScan, Thomson Reuters) was performed for Commercial insurer and Medicare databases between January 2000 and March 2011. A retrospective analysis of contemporaneous penile prosthesis implantation at the Johns Hopkins Hospital (JHH) was done. Population demographics, comorbidities, previous (ED) therapies and time from ED diagnosis to surgery were assessed. Median ages for patients undergoing penile prosthesis implantation were 58, 70 and 63 years for the Commercial, Medicare and JHH cohorts, respectively. For the claim databases (Commercial, Medicare, respectively), hypertension (72%, 78%), dyslipidemia (71%, 56%) and diabetes mellitus (45%, 40%) were predominant comorbidities, whereas for the JHH database prostate cancer (51%) and its management by prostatectomy (45%) or radiation (12%) were predominant. Previous use of PDE5 inhibitors was similar across databases (60, 58 and 69% for Commercial, Medicare and JHH cohorts, respectively), although previous use of non-oral ED therapies was greater in the JHH database. Median time to surgery from initial ED diagnosis was 2, 2 and 4 years for the Commercial, Medicare and JHH patients, respectively. Demographic variables and ED risk factors associated with penile prosthesis surgery at a national population-based level over a contemporary period were defined. Some differences in utilization trends of penile prosthesis surgery exist at a single institutional level.

National Practice Patterns of Treatment of Erectile Dysfunction with Penile Prosthesis Implantation

“…However, few groups have examined surgical preferences for ED treatment and those available relied on limited national sampling database studies or recall biased practitioner surveys. 10,11 The most relevant study of penile prosthesis practice trends, that by Gee et al, was published 18 years ago. 14 To our knowledge our analysis of case log data from certifying and recertifying urologists is the first evaluation of penile prosthesis implantation surgical case logs in the United States.…”

“…2,3 Several studies suggest that surgeon and facility volumes of prosthesis surgery may influence surgical outcomes. 10,11 However, to our knowledge there has been no contemporary evaluation of the actual surgical practice patterns of penile prosthesis surgery in the United States to date.…”

Utilization of penile prosthesis and male incontinence prosthetics in Saudi Arabia

“…This is different from Medicare, for instance, which covers the procedure in its entirety from the perspective that it is an Food and Drug Administration-approved functional treatment not a cosmetic procedure. [ 11 ]…”

Novel Emerging Therapies for Erectile Dysfunction

“…The most common device implanted in penile surgery is the three-piece inflatable penile prosthesis (IPP) [46]. The 5-and 10-year overall survival of modern prosthetics is estimated to be 90.4% and 86.6%, respectively [47].…”