Document Detail


Self-reported volume of radical prostatectomies among urologists in the USA.
MedLine Citation:
PMID:  17155974     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the variability in the volume of radical retropubic prostatectomy (RP) performed by urologists in the USA, and the physician characteristics that predict RP volume, as previous studies showed that individual surgeon volume for RP is associated with clinical outcomes. METHODS: In a nationwide, representative survey of 2000 urologists who treat prostate carcinoma in the USA, we asked respondents to indicate a numerical range of RPs they perform each year (none, 1-10, 11-30, and >30, the last which we defined as 'high volume'). We then identified characteristics of the provider and practice associated with a high volume of RPs. Supplementing survey results with other national data, we estimated the proportion of all RPs in the USA performed by 'high-volume' urologists. RESULTS: The survey response rate was 66.1% (1313 urologists) with no differences between the respondents and non-respondents for the measured demographic variables. Among urologists who performed RPs (89.1% of the sample), 37.3% did < or = 10, 46.9% 11-30 and 15.8% >30 RPs/year. Academic and urological oncology fellowship-trained urologists were, respectively, 41% and 27% more likely than private-practice and non-fellowship-trained urologists to have a high volume of RPs. Of all RPs performed yearly in the USA, only an estimated 46.1% were by high-volume urologists. CONCLUSION: A significant proportion of urologists report a RP volume that might be associated with higher rates of cardiac, respiratory, vascular, wound-healing, and genitourinary complications. Further study is needed to characterize the possible relationships between RP volume and tumour recurrence, survival, and long-term erectile dysfunction and incontinence.
Authors:
Thomas D Denberg; Robert C Flanigan; Fernando J Kim; Richard M Hoffman; John F Steiner
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Multicenter Study; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2006-11-28
Journal Detail:
Title:  BJU international     Volume:  99     ISSN:  1464-4096     ISO Abbreviation:  BJU Int.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-02-22     Completed Date:  2007-03-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  339-43     Citation Subset:  IM    
Affiliation:
General Internal Medicine, Denver Health Center, University of Colorado Health Sciences Center, Denver, CO 80262, USA. tom.denberg@uchsc.edu
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MeSH Terms
Descriptor/Qualifier:
Erectile Dysfunction / etiology
Health Surveys
Humans
Male
Middle Aged
Neoplasm Recurrence, Local / etiology
Physician's Practice Patterns*
Postoperative Complications / etiology*
Prostatectomy / adverse effects,  statistics & numerical data*
Prostatic Neoplasms / mortality,  surgery*
Survival Analysis
United States
Urinary Incontinence / etiology
Urology / statistics & numerical data*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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