Impact of Surgeon Case Volume on Reoperation Rates after Inflatable Penile Prosthesis Surgery

Ifeanyi C. Onyeji, Wilson Sui, Mathew J. Pagano, Aaron C. Weinberg, Maxwell B. James, Marissa C. Theofanides, Doron S. Stember, Christopher B. Anderson, Peter J. Stahl

Research output: Contribution to journalArticlepeer-review

38 Scopus citations

Abstract

Purpose We investigated the impact of surgeon annual case volume on reoperation rates after inflatable penile prosthesis surgery. Materials and Methods The New York Statewide Planning and Research Cooperative System database was queried for inflatable penile prosthesis cases from 1995 to 2014. Multivariate proportional hazards regression was performed to estimate the impact of surgeon annual case volume on inflatable penile prosthesis reoperation rates. We stratified our analysis by indication for reoperation to determine if surgeon volume had a similar effect on infectious and noninfectious complications. Results A total of 14,969 men underwent inflatable penile prosthesis insertion. Median followup was 95.1 months (range 0.5 to 226.7) from the time of implant. The rates of overall reoperation, reoperation for infection and reoperation for noninfectious complications were 6.4%, 2.5% and 3.9%, respectively. Implants placed by lower volume implanters were more likely to require reoperation for infection but not for noninfectious complications. Multivariable analysis demonstrated that compared with patients treated by surgeons in the highest quartile of annual case volume (more than 31 cases per year), patients treated by surgeons in the lowest (0 to 2 cases per year), second (3 to 7 cases per year) and third (8 to 31 cases per year) annual case volume quartiles were 2.5 (p <0.001), 2.4 (p <0.001) and 2.1 (p=0.01) times more likely to require reoperation for inflatable penile prosthesis infection, respectively. Conclusions Patients treated by higher volume implanters are less likely to require reoperation after inflatable penile prosthesis insertion than those treated by lower volume surgeons. This trend appears to be driven by associations between surgeon volume and the risk of prosthesis infection.

Original languageEnglish (US)
Pages (from-to)223-229
Number of pages7
JournalJournal of Urology
Volume197
Issue number1
DOIs
StatePublished - Jan 1 2017
Externally publishedYes

Keywords

  • infection
  • penile prosthesis
  • postoperative complications

ASJC Scopus subject areas

  • Urology

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