PURPOSE: To investigate trends in urinary diversion usage and surgeon characteristics in the utilization of incontinent and continent urinary diversions using data from American Board of Urology.
METHODS: Annualized case log data for urinary diversions were obtained from the American Board of Urology for urologists certifying or recertifying, from 2002 to 2010. We evaluated the association between surgeon characteristics and the use of any urinary diversion or the type of urinary diversion.
RESULTS: Of 5,096 certifying or recertifying urologist case logs examined, 37% (n=1,868) performed any urinary diversions. The median number was 4 per year (IQR 2-6),4% (n=222) performed =10 per year. On multivariable analysis, younger urologists, those self-identified as oncologists or female urologists, certifying in more recent years, in larger practice areas, or outside of the Northeast region of the United States were more likely to perform any urinary diversions. Only 9% (n=471) of the total cohort performed any continent urinary diversions. The likelihood of performing any continent urinary diversions increased with the number of urinary diversions (p < 0.0001), and as the volume of urinary diversions increased, the proportion of these made up by continent urinary diversions also increased (p < 0.0005). Surgeons in private practice settings or located in the Northeast were less likely to perform continent urinary diversions.
CONCLUSION: A minority of urologists performs any urinary diversions, and continent urinary diversions are most frequently performed by high volume surgeons. The type of urinary diversion a patient receives may depend, in part, on the characteristics of their surgeon.
Silberstein JL, Poon SA, Maschino AC, Lowrance WT, Garg T, Herr HW, Donat SM, Dalbagni G, Bochner BH, Sandhu JS. Are you the author?
Department of Surgery, Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan-Kettering Cancer Center, New York, NY.
Reference: J Urol. 2012 Sep 22. pii: S0022-5347(12)04948-8.