Poster, Podium & Video Sessions
Presentation Authors: Wai Lee*, Andrew Chen, Olga Povcher, Kailash Kapadia, Wei Hou, Jason Kim, Stony Brook, NY
Introduction: With the number of indications increasing for sacral neuromodulation (SNM), multiple surgical specialties are now performing the procedure. However, it is unknown what proportion of implants are being performed by each specialty. The level of training of those performing SNM implants has also never been studied. We aim to assess trends in Interstim® generator implants and subsequent revisions or removals performed in New York state.
Methods: The Statewide Planning and Research Cooperative System (SPARCS) is a comprehensive all payer data reporting system that collects patient level details on hospital and outpatient visits in New York State. We queried all SNM generator implantations from 2011 to 2014 (CPT code 94590) as well as device revision or removal (CPT codes 94585 and 94595).
Results: From 2011-2014, a total 1,454 implants were performed in NYS. 60.5%, 14.8%, and 19.2% were performed by urologists, gynecologists, and colorectal surgeons (CRS), respectively. 44% (408/931) of urology implants and 64% (146/228) gynecology implants were performed by Female Pelvic Medicine and Reconstructive Surgery (FPMRS) trained physicians. The number of cases performed by urologists decreased significantly in 2014 while CRS nearly doubled the number of implants performed each year from 2011 to 2013 (Figure 1). 8.5% of implants required subsequent revision or removal during this time period. There were no statistical differences in Interstim® revision or removal rates between implants performed by urologists (9.0%), gynecologists (10.1%), or CRS (5.4%, p=0.097). There was also no statistical difference in revision or removal rates when comparing implants performed by those with a fellowship in FPMRS (9.9%) and those without (11.4%, p=0.414).
Conclusions: In recent years, SNM implantation has been primarily performed by urologists in NYS. Following FDA approval of Interstim® for fecal incontinence in 2011, CRS have dramatically increased the number of cases they perform. Neither surgical specialty nor FPMRS fellowship training appear to affect revision or removal rates in the short term.
Source Of Funding: none
Stony Brook Medicine
Wai Lee is a PGY5 (out of 6 year) urology resident at Stony Brook. He grew up in NYC and went to medical school at Stony Brook School of Medicine. His plan is to pursue a fellowship in Female Pelvic Medicine & Reconstructive Surgery. His research interests include socioeconomics, surgical videos, neuromodulation and outcomes research. He has been a member of the AUA since 2012.
Friday, May 12
10:50 AM – 11:00 AM
Monday, May 15
11:20 AM – 11:30 AM