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Insufficient utilization of care in male incontinence surgery: health care reality in Germany from 2006 to 2020 and a systematic review of the international literature

PURPOSE: Data suggest that the utilization of care in male incontinence surgery (MIS) is insufficient. The aim of this study was to analyse the utilization of care in MIS from 2006 to 2020 in Germany, relate this use to the number of radical prostatectomies (RP) and provide a systematic review of th...

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Autores principales: Baunacke, Martin, Abbate, Elena, Eisenmenger, Nicole, Witzsch, Ulrich, Borkowetz, Angelika, Huber, Johannes, Thomas, Christian, Putz, Juliane
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10233526/
https://www.ncbi.nlm.nih.gov/pubmed/37261500
http://dx.doi.org/10.1007/s00345-023-04433-9
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author Baunacke, Martin
Abbate, Elena
Eisenmenger, Nicole
Witzsch, Ulrich
Borkowetz, Angelika
Huber, Johannes
Thomas, Christian
Putz, Juliane
author_facet Baunacke, Martin
Abbate, Elena
Eisenmenger, Nicole
Witzsch, Ulrich
Borkowetz, Angelika
Huber, Johannes
Thomas, Christian
Putz, Juliane
author_sort Baunacke, Martin
collection PubMed
description PURPOSE: Data suggest that the utilization of care in male incontinence surgery (MIS) is insufficient. The aim of this study was to analyse the utilization of care in MIS from 2006 to 2020 in Germany, relate this use to the number of radical prostatectomies (RP) and provide a systematic review of the international literature. METHODS: We analysed OPS codes using nationwide German billing data and hospitals’ quality reports from 2006 to 2020. A systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). RESULTS: MIS increased by + 68% from 2006 to 2011 (1843–3125; p = 0.009) but decreased by − 42% from 2011 to 2019 (3104–1799; p < 0.001). In 2020, only 1435 MISs were performed. In contrast, RP increased from 2014 to 2019 by 33% (20,760–27,509; p < 0.001). From 2012 to 2019, the number of artificial urinary sphincters (AUSs) changed minimally (− 12%; 1291–1136; p = 0.02). Sling/sling systems showed a decrease from 2011 to 2019 (− 68% 1632–523; p < 0.001). In 2019, 63% of patients received an AUS, 29% sling/sling systems, 6% paraurethral injections, and 2% other interventions. In 2019, few high-volume clinics [n = 27 (13%)] performed 55% of all AUS implantations, and few high-volume clinics [n = 10 (8%)] implanted 49% of retropubic slings. CONCLUSION: MIS have exhibited a relevant decrease since 2011 despite the increase in RP numbers in Germany, indicating the insufficient utilization of care in MIS. The systematic review shows also an international deficit in the utilization of care in MIS. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00345-023-04433-9.
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spelling pubmed-102335262023-06-01 Insufficient utilization of care in male incontinence surgery: health care reality in Germany from 2006 to 2020 and a systematic review of the international literature Baunacke, Martin Abbate, Elena Eisenmenger, Nicole Witzsch, Ulrich Borkowetz, Angelika Huber, Johannes Thomas, Christian Putz, Juliane World J Urol Original Article PURPOSE: Data suggest that the utilization of care in male incontinence surgery (MIS) is insufficient. The aim of this study was to analyse the utilization of care in MIS from 2006 to 2020 in Germany, relate this use to the number of radical prostatectomies (RP) and provide a systematic review of the international literature. METHODS: We analysed OPS codes using nationwide German billing data and hospitals’ quality reports from 2006 to 2020. A systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). RESULTS: MIS increased by + 68% from 2006 to 2011 (1843–3125; p = 0.009) but decreased by − 42% from 2011 to 2019 (3104–1799; p < 0.001). In 2020, only 1435 MISs were performed. In contrast, RP increased from 2014 to 2019 by 33% (20,760–27,509; p < 0.001). From 2012 to 2019, the number of artificial urinary sphincters (AUSs) changed minimally (− 12%; 1291–1136; p = 0.02). Sling/sling systems showed a decrease from 2011 to 2019 (− 68% 1632–523; p < 0.001). In 2019, 63% of patients received an AUS, 29% sling/sling systems, 6% paraurethral injections, and 2% other interventions. In 2019, few high-volume clinics [n = 27 (13%)] performed 55% of all AUS implantations, and few high-volume clinics [n = 10 (8%)] implanted 49% of retropubic slings. CONCLUSION: MIS have exhibited a relevant decrease since 2011 despite the increase in RP numbers in Germany, indicating the insufficient utilization of care in MIS. The systematic review shows also an international deficit in the utilization of care in MIS. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00345-023-04433-9. Springer Berlin Heidelberg 2023-06-01 2023 /pmc/articles/PMC10233526/ /pubmed/37261500 http://dx.doi.org/10.1007/s00345-023-04433-9 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Baunacke, Martin
Abbate, Elena
Eisenmenger, Nicole
Witzsch, Ulrich
Borkowetz, Angelika
Huber, Johannes
Thomas, Christian
Putz, Juliane
Insufficient utilization of care in male incontinence surgery: health care reality in Germany from 2006 to 2020 and a systematic review of the international literature
title Insufficient utilization of care in male incontinence surgery: health care reality in Germany from 2006 to 2020 and a systematic review of the international literature
title_full Insufficient utilization of care in male incontinence surgery: health care reality in Germany from 2006 to 2020 and a systematic review of the international literature
title_fullStr Insufficient utilization of care in male incontinence surgery: health care reality in Germany from 2006 to 2020 and a systematic review of the international literature
title_full_unstemmed Insufficient utilization of care in male incontinence surgery: health care reality in Germany from 2006 to 2020 and a systematic review of the international literature
title_short Insufficient utilization of care in male incontinence surgery: health care reality in Germany from 2006 to 2020 and a systematic review of the international literature
title_sort insufficient utilization of care in male incontinence surgery: health care reality in germany from 2006 to 2020 and a systematic review of the international literature
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10233526/
https://www.ncbi.nlm.nih.gov/pubmed/37261500
http://dx.doi.org/10.1007/s00345-023-04433-9
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