To evaluate trends in Urogynecologic and Reconstructive Pelvic Surgery (URPS) among early-career urologists, comparing URPS-trained and non-URPS urologists using American Board of Urology (ABU) case logs from 2009 to 2020.
Six-month ABU case logs from 3113 early-career urologists were analyzed. Procedures included sling placement and urethral bulking for stress urinary incontinence (SUI), transvaginal prolapse repair and sacrocolpopexy for pelvic organ prolapse, and intravesical Botox injection and sacral neuromodulation (SNM) for overactive bladder (OAB).
URPS urologists performed higher mean case volumes for SUI (sling: 11 vs 5, p < 0.01; bulking: 8 vs 4, p < 0.01), prolapse (transvaginal: 8 vs 4, p < 0.001; sacrocolpopexy: 6 vs 3, p < 0.001), and OAB procedures (Botox: 10 vs 4.5, p < 0.001; SNM: 13.2 vs 7.9, p < 0.001) than non-URPS urologists. URPS training was associated with higher odds of performing these procedures (ORs 8.3-25.2, 95% CI [5.97-45.84] p < 0.01). The proportion of non-URPS urologists performing SUI and prolapse procedures declined over years (Spearman's ρ = -0.79 to -0.94, p < 0.01), while the adoption of OAB procedures increased.
Our findings revealed a gradual shift in practice pattern towards increasing subspecialization, particularly for SUI and prolapse surgeries. Interestingly minimally invasive OAB treatments are increasingly adopted by non-URPS urologists, likely due to improvement in surgical techniques and the development of new technology.
Urology. 2025 Sep 23 [Epub ahead of print]
Zhenyue Huang, Tal Cohen, Kelly Ieong, Jason Zhang, Michael Ernst, Steve Weissbart, Justina Tam, Jason Kim
Stony Brook University Hospital, Department of Urology, Stony brook, NY. Electronic address: ., Stony Brook University Hospital, Department of Urology, Stony brook, NY. Electronic address: ., Stony Brook University Hospital, Department of Urology, Stony brook, NY. Electronic address: ., Renaissance School of Medicine at Stony Brook University, Stony Brook, NY. Electronic address: ., Stony Brook University Hospital, Department of Urology, Stony brook, NY. Electronic address: ., Stony Brook University Hospital, Department of Urology, Stony brook, NY. Electronic address: ., Stony Brook University Hospital, Department of Urology, Stony brook, NY. Electronic address: ., Stony Brook University Hospital, Department of Urology, Stony brook, NY. Electronic address: .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/40998054