The cost of surveillance after urethroplasty

Uwais B. Zaid, Mitchel Hawkins, Leslie Wilson, Jie Ting, Catherine Harris, Amjad Alwaal, Lee C. Zhao, Allen F. Morey, Benjamin N. Breyer

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

OBJECTIVE: To determine variability in urethral stricture surveillance. Urethral strictures impact quality of life and exact a large economic burden. Although urethroplasty is the gold standard for durable treatment, strictures recur in 8%-18%. There are no universally accepted guidelines for posturethroplasty surveillance. We performed a literature search to evaluate variability in surveillance protocols, analyzed costs, and reviewed performance of each commonly used modality.

METHODS: MEDLINE search was performed using the keywords "urethroplasty," "urethral stricture," and "stricture recurrence" to ascertain commonly used surveillance strategies for stricture recurrence. We included English language articles from the past 10 years with at least 10 patients, and age >18 years. Cost data were calculated based on standard 2013 Centers for Medicare and Medicaid Services physician's fees.

RESULTS: Surveillance methods included retrograde urethrogram or voiding cystourethrogram, cystourethroscopy, urethral ultrasound, American Urological Association Symptom Score, and postvoid residual and urine flowmetry (UF) measurement. Most protocols call for a retrograde urethrogram or voiding cystourethrogram at the time of catheter removal. After this, UF or PVR, cystoscopy, urine culture, or a combination of UF and American Urological Association Symptom Score was performed at variable intervals. The first-year follow-up cost of anterior urethral surgery ranged from $205 to $1784. For posterior urethral surgery, follow-up cost for the first year ranged from $404 to $961.

CONCLUSION: Practice variability for surveillance of urethral stricture recurrence after urethroplasty leads to significant differences in cost.

Original languageEnglish (US)
Pages (from-to)1195-1199
Number of pages5
JournalUrology
Volume85
Issue number5
DOIs
StatePublished - May 1 2015

Fingerprint

Urethral Stricture
Rheology
Costs and Cost Analysis
Urine
Pathologic Constriction
Recurrence
Centers for Medicare and Medicaid Services (U.S.)
Cystoscopy
Fees and Charges
MEDLINE
Language
Catheters
Economics
Quality of Life
Guidelines
Physicians
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Zaid, U. B., Hawkins, M., Wilson, L., Ting, J., Harris, C., Alwaal, A., ... Breyer, B. N. (2015). The cost of surveillance after urethroplasty. Urology, 85(5), 1195-1199. https://doi.org/10.1016/j.urology.2014.12.047

The cost of surveillance after urethroplasty. / Zaid, Uwais B.; Hawkins, Mitchel; Wilson, Leslie; Ting, Jie; Harris, Catherine; Alwaal, Amjad; Zhao, Lee C.; Morey, Allen F.; Breyer, Benjamin N.

In: Urology, Vol. 85, No. 5, 01.05.2015, p. 1195-1199.

Research output: Contribution to journalArticle

Zaid, UB, Hawkins, M, Wilson, L, Ting, J, Harris, C, Alwaal, A, Zhao, LC, Morey, AF & Breyer, BN 2015, 'The cost of surveillance after urethroplasty', Urology, vol. 85, no. 5, pp. 1195-1199. https://doi.org/10.1016/j.urology.2014.12.047
Zaid UB, Hawkins M, Wilson L, Ting J, Harris C, Alwaal A et al. The cost of surveillance after urethroplasty. Urology. 2015 May 1;85(5):1195-1199. https://doi.org/10.1016/j.urology.2014.12.047
Zaid, Uwais B. ; Hawkins, Mitchel ; Wilson, Leslie ; Ting, Jie ; Harris, Catherine ; Alwaal, Amjad ; Zhao, Lee C. ; Morey, Allen F. ; Breyer, Benjamin N. / The cost of surveillance after urethroplasty. In: Urology. 2015 ; Vol. 85, No. 5. pp. 1195-1199.
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AU - Zhao, Lee C.

AU - Morey, Allen F.

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N2 - OBJECTIVE: To determine variability in urethral stricture surveillance. Urethral strictures impact quality of life and exact a large economic burden. Although urethroplasty is the gold standard for durable treatment, strictures recur in 8%-18%. There are no universally accepted guidelines for posturethroplasty surveillance. We performed a literature search to evaluate variability in surveillance protocols, analyzed costs, and reviewed performance of each commonly used modality.METHODS: MEDLINE search was performed using the keywords "urethroplasty," "urethral stricture," and "stricture recurrence" to ascertain commonly used surveillance strategies for stricture recurrence. We included English language articles from the past 10 years with at least 10 patients, and age >18 years. Cost data were calculated based on standard 2013 Centers for Medicare and Medicaid Services physician's fees.RESULTS: Surveillance methods included retrograde urethrogram or voiding cystourethrogram, cystourethroscopy, urethral ultrasound, American Urological Association Symptom Score, and postvoid residual and urine flowmetry (UF) measurement. Most protocols call for a retrograde urethrogram or voiding cystourethrogram at the time of catheter removal. After this, UF or PVR, cystoscopy, urine culture, or a combination of UF and American Urological Association Symptom Score was performed at variable intervals. The first-year follow-up cost of anterior urethral surgery ranged from $205 to $1784. For posterior urethral surgery, follow-up cost for the first year ranged from $404 to $961.CONCLUSION: Practice variability for surveillance of urethral stricture recurrence after urethroplasty leads to significant differences in cost.

AB - OBJECTIVE: To determine variability in urethral stricture surveillance. Urethral strictures impact quality of life and exact a large economic burden. Although urethroplasty is the gold standard for durable treatment, strictures recur in 8%-18%. There are no universally accepted guidelines for posturethroplasty surveillance. We performed a literature search to evaluate variability in surveillance protocols, analyzed costs, and reviewed performance of each commonly used modality.METHODS: MEDLINE search was performed using the keywords "urethroplasty," "urethral stricture," and "stricture recurrence" to ascertain commonly used surveillance strategies for stricture recurrence. We included English language articles from the past 10 years with at least 10 patients, and age >18 years. Cost data were calculated based on standard 2013 Centers for Medicare and Medicaid Services physician's fees.RESULTS: Surveillance methods included retrograde urethrogram or voiding cystourethrogram, cystourethroscopy, urethral ultrasound, American Urological Association Symptom Score, and postvoid residual and urine flowmetry (UF) measurement. Most protocols call for a retrograde urethrogram or voiding cystourethrogram at the time of catheter removal. After this, UF or PVR, cystoscopy, urine culture, or a combination of UF and American Urological Association Symptom Score was performed at variable intervals. The first-year follow-up cost of anterior urethral surgery ranged from $205 to $1784. For posterior urethral surgery, follow-up cost for the first year ranged from $404 to $961.CONCLUSION: Practice variability for surveillance of urethral stricture recurrence after urethroplasty leads to significant differences in cost.

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