US patterns of care for urodynamic evaluation for BPH.

Area of Science:

• Urology
• Surgical Practice Patterns
• Diagnostic Evaluation

Background:

• Practice patterns for urodynamic evaluation (UDS) in benign prostatic hyperplasia (BPH) surgery are not well-defined.
• Understanding factors influencing UDS use is crucial for optimizing patient care.

Purpose of the Study:

• To investigate patient- and surgeon-related factors associated with UDS utilization for BPH surgeries.
• To identify trends in UDS usage for BPH over time.

Main Methods:

• Analysis of American Board of Urology case log data from 2008 to 2020.
• Logistic regression models were employed to determine factors associated with UDS usage for BPH.

Main Results:

• UDS utilization for BPH declined from 2008-2020 (OR: 0.95).
• Factors associated with higher UDS use included male gender, older age, female pelvic medicine and reconstructive surgery subspecialty, and higher BPH surgical case volume.
• Urologists performing UDS were more likely to practice in the Mid-Atlantic region and in areas with larger populations.

Conclusions:

• Significant practice variations exist in the use of UDS for BPH.
• Despite increasing BPH surgeries, urologists are performing UDS less frequently for BPH.
• Higher BPH surgical volume among UDS users suggests UDS may not be a primary factor in surgical decision-making.