Recent Trends in Transurethral Surgeries and Urological Outpatient Procedures: a Nationwide Population-based Cohort Study

BACKGROUND: Demographic change and advances in technology affect transurethral surgery and outpatient procedures in the urologic field. There are few population-based studies that accurately assess the trend of transurethral surgery and outpatient procedures including diagnostic tests. We investigated the recent epidemiologic trends in transurethral surgeries and urological outpatient procedures from 2009 to 2016 in Korea using the entire population-based cohort. METHODS: We analyzed medical service claim data of transurethral surgery, urological outpatient procedures submitted by medical service providers from the Health Insurance Review and Assessment Service from 2009 to 2016. RESULTS: Transurethral ureter surgery increased by 134.9% from 14,635 in 2009 to 34,382 in 2016 (B = 2,698; R(2) = 0.98; P < 0.001). The transurethral bladder surgery increased by 65.5% from 12,482 in 2009 to 20,658 in 2016 (B = 1,149; R(2) = 0.97; P < 0.001). Over the 8-years period, there were not significant changes in transurethral prostate (B = 43; R(2) = 0.04; P = 0.617) and urethral surgery (B = −12; R(2) = 0.18; P = 0.289). The significantly increasing trends in cystoscopy (B = 5,260; R(2) = 0.95; P < 0.001) and uroflowmetry (B = 53,942; R(2) = 0.99; P < 0.001) were observed during the 8-year period. There was no difference in bladder catheterization during the 8-year period. Urodynamic study (UDS: B = −2,156; R(2) = 0.77; P = 0.003) and electrical stimulation treatment (EST: B = −1,034; R(2) = 0.87; P < 0.001) significantly decreased. CONCLUSION: In Korea, transurethral ureter surgery and transurethral bladder surgery have been continuously increasing. Transurethral prostate surgery and transurethral urethral surgery remained constant with no increase or decrease. Cystoscopy and uroflowmetry continue to increase, while UDS and EST continue to decrease.