Document Detail


Trends in stricture management among male Medicare beneficiaries: underuse of urethroplasty?
MedLine Citation:
PMID:  21168194     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To analyze the trends in male urethral stricture management using the 1992-2001 Medicare claims data and to determine whether certain racial and ethnic groups have a disproportionate burden of urethral stricture disease.
METHODS: We analyzed the Medicare claims for fiscal years 1992, 1995, 1998, and 2001. The "International Classification of Disease, 9th revision," diagnosis codes were used to identify men with urethral stricture. The demographic characteristics assessed included patient age, race, and comorbidities, as measured using the Charlson index. Treatments were identified using the Physician Current Procedural Terminology Coding System, 4th edition, procedure codes and stratified into 4 treatment types: urethral dilation, direct vision internal urethrotomy, urethral stent/steroid injection, and urethroplasty.
RESULTS: The overall rates of stricture diagnosis decreased from 10,088/100,000 population in 1992 to 6897 in 2001 (from 1.4% to 0.9%). The stricture prevalence was greatest among black and Hispanic men, although the urethroplasty rates were greatest among white men. Direct vision internal urethrotomy was the most common treatment, followed by urethral dilation, urethral stent/steroid injection, and urethroplasty. The urethroplasty rates remained stable, but quite low (0.6%-0.8%), during the study period.
CONCLUSIONS: The overall rates of stricture diagnosis decreased from 1992 to 2001. Despite the poor overall efficacy of urethrotomy and urethral dilation relative to urethroplasty and despite the known complications of stent placement in this setting, the urethroplasty rates were the lowest of all treatments. Although we could not determine the treatment success with these data, these findings suggest an underuse of the most efficacious treatment of urethral stricture disease, urethroplasty.
Authors:
Jennifer T Anger; Jill C Buckley; Richard A Santucci; Sean P Elliott; Christopher S Saigal;
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2010-12-18
Journal Detail:
Title:  Urology     Volume:  77     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-07     Completed Date:  2011-03-23     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  481-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2011. Published by Elsevier Inc.
Affiliation:
Department of Urology, University of California, Los Angeles, School of Medicine, Los Angeles, California, USA. janger@mednet.ucla.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Humans
Male
Medicare / statistics & numerical data*
Middle Aged
United States
Urethral Stricture / surgery*
Urologic Surgical Procedures, Male / methods,  trends,  utilization
Grant Support
ID/Acronym/Agency:
N01 DK012460/DK/NIDDK NIH HHS
Comments/Corrections
Comment In:
Urology. 2011 Feb;77(2):485-6   [PMID:  21295257 ]

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


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