1667 POPULATION BASED TRENDS IN SURGICAL TREATMENT OF ERECTILE DYSFUNCTION

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Peyronie Disease + Surgical Therapy1 Apr 20131667 POPULATION BASED TRENDS IN SURGICAL TREATMENT OF ERECTILE DYSFUNCTION Hossein S. Mirheydar, Kerrin L. Palazzi, J. Kellogg Parsons, David C. Chang, and T. Mike Hsieh Hossein S. MirheydarHossein S. Mirheydar La Jolla, CA More articles by this author , Kerrin L. PalazziKerrin L. Palazzi La Jolla, CA More articles by this author , J. Kellogg ParsonsJ. Kellogg Parsons La Jolla, CA More articles by this author , David C. ChangDavid C. Chang La Jolla, CA More articles by this author , and T. Mike HsiehT. Mike Hsieh La Jolla, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.3081AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES It is estimated that erectile dysfunction affects up to 30 million American men. Available treatment options include vacuum erection device, phosphodiesterase V inhibitors, intracavernosal injections, and penile prosthetic surgery. We sought to examine surgical trends over time for the treatment of erectile dysfunction and to identify patient specific factors that predicted receipt of inflatable versus semi-rigid penile prosthesis. METHODS The State of California Office of Statewide Health Planning and Development provides a 100% sample of inpatient surgeries performed between 1995 and 2010. Penile prosthetic surgery were captured using ICD-9 codes in patients ≥50 years old. The primary endpoint was total number of implants performed and the proportion of inflatable versus semi-rigid prosthesis, which was calculated annually. We used multivariate regression analysis to examine patient factors associated with the selection of inflatable vs. semi-rigid penile prosthesis. RESULTS We identified 7,054 penile prostheses (6,183 inflatable and 1,321 semi-rigid) between 1995 and 2010. The total number of penile implants performed annually decreased from 760 (1995) to 318 (2010), p<0.001. The proportion of inflatable prostheses increased significantly from 78.4% to 88.4% (p=0.003) between 2001 and 2010. In 2010, the total number of implants reached a nadir (n=318). Significantly larger proportions of African-Americans (p<0.001), Medicaid (p<0.001), diabetic (p<0.001), hypertensive (p=0.027), spinal cord injury (SCI; p<0.001), and obese (p=0.001) patients received semi-rigid prosthesis. Inflatable prosthesis incurred higher cost ($40,941 vs. $19,248, p<0.001), with similar lengths of stay (p=0.127). In multivariate analysis, Caucasian and non-SCI injured men were more likely to receive inflatable prosthesis (p<0.001). Insurance carrier did not influence surgical selection. CONCLUSIONS Utilization of penile prosthetic surgery has decreased significantly in the state of California between 1995 and 2010. The proportion of inflatable penile prostheses has increased between 2001 and 2010. Caucasian and non-spinal cord injured men were more likely to receive an inflatable penile prosthesis. The development of antibiotic coated inflatable penile prosthesis may explain the increase in the proportion of inflatable penile prostheses performed since 2001. The overall decrease in volume of penile prostheses performed is likely multifactorial, and warrants further investigation. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e686 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hossein S. Mirheydar La Jolla, CA More articles by this author Kerrin L. Palazzi La Jolla, CA More articles by this author J. Kellogg Parsons La Jolla, CA More articles by this author David C. Chang La Jolla, CA More articles by this author T. Mike Hsieh La Jolla, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...