title: Hospital-based trends in penile prosthetic surgery.
abstract: BACKGROUND
  We examined national and regional trends in hospital-based penile prosthetic surgery and identified patient-specific factors predicting receipt of inflatable vs. semi-rigid penile prostheses.
  
  
  OBJECTIVE
  To improve our understanding of the surgical treatment for erectile dysfunction (ED).
  
  
  METHODS
  We utilized the Nationwide Inpatient Sample (NIS) from 1998 to 2010 in the United States and the California Office of Statewide Health Planning and Development (OSHPD) database from 1995 to 2010. Total number of penile implants performed and proportions of inflatable vs. semi-rigid prosthesis were examined. Multivariate analysis (MVA) was performed to identify factors associated with selection of inflatable vs. semi-rigid prostheses.
  
  
  METHODS
  Primary outcome measure is the total number of hospital-based penile prosthetic surgeries performed in the United States over a 12-year period (1998-2010). Secondary outcome measures include proportion of inflatable and semi-rigid prosthesis implantations and factors influencing receipt of different prostheses.
  
  
  RESULTS
  We identified 53,967 penile prosthetic surgeries in the NIS; annual number implanted decreased from 4,703 to 2,338. Inflatable prostheses incurred higher costs but had a similar length of stay (LOS). In MVA, Caucasian race, Peyronie's disease, and private insurance were independently associated with receipt of an inflatable prosthesis. We identified 7,054 penile prostheses in OSHPD; annual number implanted decreased from 760 to 318. The proportion of inflatable prostheses increased significantly from 78.4% to 88.4% between 2001 and 2010. Inflatable prostheses incurred higher costs but had similar median LOS. In MVA, Caucasians and men without spinal cord injury were more likely to receive inflatable prosthesis.
  
  
  CONCLUSIONS
  Hospital-based penile prosthetic surgery has decreased substantially both nationwide and in California. In the United States, Caucasian race, Peyronie's disease, and private insurance were independently associated with receipt of an inflatable penile prosthesis. California population data correlated with national trends and can be utilized to further study surgical management of ED.
authors: Department of Urology, UC San Diego Health System, San Diego, CA, USA.
authors: Hossein S
authors: HS
authors: Mirheydar
authors: Kerrin L
authors: KL
authors: Palazzi
authors: J Kellogg
authors: JK
authors: Parsons
authors: David
authors: D
authors: Chang
authors: Tung-Chin
authors: TC
authors: Hsieh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California; D007172:Erectile Dysfunction / Q000601:surgery*; D006801:Humans; D007345:Insurance Claim Review; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D015917:Penile Prosthesis / Q000706:statistics & numerical data*; D019919:Prosthesis Implantation / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States
keywords: Erectile Dysfunction; Penile Prosthetic Surgery; Population Trends