Disparities in female urologic case distribution with new subspecialty certification and surgeon gender

Joceline S. Liu, Laura Jo Dickmeyer, Oluwarotimi Nettey, Matthias Dominikus Hofer, Sarah C Flury, Stephanie J Kielb*

*Corresponding author for this work

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Aims: To examine surgical case volume characteristics in certifying urologists associated with common female urologic procedures to evaluate the practice patterns, given the recent establishment of subspecialty certification in Female Pelvic Medicine and Reconstructive Surgery (FPMRS) and changes in urologist gender composition. Methods: Six-month case log data of certifying urologists (2003–2013) was obtained from the American Board of Urology (ABU). We examined case logs for 26 CPT codes for common female urologic procedures focused on four procedure groups: incontinence, prolapse, vesicovaginal fistula (VVF), and revision/removal of vaginal mesh/graft. Results: Among 4802 urologists logging at least one female urology case, 43,949 (55.6% of all cases) incontinence, 30,983 (39.2%) prolapse, 451 (0.6%) VVF, and 3643 (4.6%) revision of mesh/graft surgeries were identified. While 90.8% logging at least one female CPT code were men, women surgeons (9.2%) accounted for a disproportionate volume (22.6%) of cases. With initiation of the FPMRS subspecialty certification in 2011, 225 FPMRS candidates (out of 1716 certifying urologists) were identified, compared to 367 (out of 3828 certifying urologists) female subspecialists prior to 2011. FPMRS accounted for 56.7% of prolapse, 62.9% VVF, 59.0% mesh/graft revisions, and 41.9% of incontinence surgeries, compared to female specialists before 2011 (39.1%, 42.4%, 41.5%, and 21.6% respectively (all P < 0.001)). Conclusions: A growing proportion of female urologic cases are performed by female subspecialists, with a significant increase since initiation of FPMRS subspecialty certification. Women surgeons account for a disproportionate volume of these cases despite remaining a minority of certifying urologists and female subspecialists. Neurourol. Urodynam. 36:399–403, 2017.

Original languageEnglish (US)
Pages (from-to)399-403
Number of pages5
JournalNeurourology and Urodynamics
Volume36
Issue number2
DOIs
StatePublished - Feb 1 2017

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Certification
Reconstructive Surgical Procedures
Vesicovaginal Fistula
Medicine
Prolapse
Current Procedural Terminology
Urology
Surgeons
Transplants
Urologists

Keywords

  • american board of urology
  • female urology
  • gender
  • practice patterns

ASJC Scopus subject areas

  • Clinical Neurology
  • Urology

Cite this

@article{6c94432436f34e80aae6e42e13675366,
title = "Disparities in female urologic case distribution with new subspecialty certification and surgeon gender",
abstract = "Aims: To examine surgical case volume characteristics in certifying urologists associated with common female urologic procedures to evaluate the practice patterns, given the recent establishment of subspecialty certification in Female Pelvic Medicine and Reconstructive Surgery (FPMRS) and changes in urologist gender composition. Methods: Six-month case log data of certifying urologists (2003–2013) was obtained from the American Board of Urology (ABU). We examined case logs for 26 CPT codes for common female urologic procedures focused on four procedure groups: incontinence, prolapse, vesicovaginal fistula (VVF), and revision/removal of vaginal mesh/graft. Results: Among 4802 urologists logging at least one female urology case, 43,949 (55.6{\%} of all cases) incontinence, 30,983 (39.2{\%}) prolapse, 451 (0.6{\%}) VVF, and 3643 (4.6{\%}) revision of mesh/graft surgeries were identified. While 90.8{\%} logging at least one female CPT code were men, women surgeons (9.2{\%}) accounted for a disproportionate volume (22.6{\%}) of cases. With initiation of the FPMRS subspecialty certification in 2011, 225 FPMRS candidates (out of 1716 certifying urologists) were identified, compared to 367 (out of 3828 certifying urologists) female subspecialists prior to 2011. FPMRS accounted for 56.7{\%} of prolapse, 62.9{\%} VVF, 59.0{\%} mesh/graft revisions, and 41.9{\%} of incontinence surgeries, compared to female specialists before 2011 (39.1{\%}, 42.4{\%}, 41.5{\%}, and 21.6{\%} respectively (all P < 0.001)). Conclusions: A growing proportion of female urologic cases are performed by female subspecialists, with a significant increase since initiation of FPMRS subspecialty certification. Women surgeons account for a disproportionate volume of these cases despite remaining a minority of certifying urologists and female subspecialists. Neurourol. Urodynam. 36:399–403, 2017.",
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author = "Liu, {Joceline S.} and Dickmeyer, {Laura Jo} and Oluwarotimi Nettey and Hofer, {Matthias Dominikus} and Flury, {Sarah C} and Kielb, {Stephanie J}",
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Disparities in female urologic case distribution with new subspecialty certification and surgeon gender. / Liu, Joceline S.; Dickmeyer, Laura Jo; Nettey, Oluwarotimi; Hofer, Matthias Dominikus; Flury, Sarah C; Kielb, Stephanie J.

In: Neurourology and Urodynamics, Vol. 36, No. 2, 01.02.2017, p. 399-403.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Disparities in female urologic case distribution with new subspecialty certification and surgeon gender

AU - Liu, Joceline S.

AU - Dickmeyer, Laura Jo

AU - Nettey, Oluwarotimi

AU - Hofer, Matthias Dominikus

AU - Flury, Sarah C

AU - Kielb, Stephanie J

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Aims: To examine surgical case volume characteristics in certifying urologists associated with common female urologic procedures to evaluate the practice patterns, given the recent establishment of subspecialty certification in Female Pelvic Medicine and Reconstructive Surgery (FPMRS) and changes in urologist gender composition. Methods: Six-month case log data of certifying urologists (2003–2013) was obtained from the American Board of Urology (ABU). We examined case logs for 26 CPT codes for common female urologic procedures focused on four procedure groups: incontinence, prolapse, vesicovaginal fistula (VVF), and revision/removal of vaginal mesh/graft. Results: Among 4802 urologists logging at least one female urology case, 43,949 (55.6% of all cases) incontinence, 30,983 (39.2%) prolapse, 451 (0.6%) VVF, and 3643 (4.6%) revision of mesh/graft surgeries were identified. While 90.8% logging at least one female CPT code were men, women surgeons (9.2%) accounted for a disproportionate volume (22.6%) of cases. With initiation of the FPMRS subspecialty certification in 2011, 225 FPMRS candidates (out of 1716 certifying urologists) were identified, compared to 367 (out of 3828 certifying urologists) female subspecialists prior to 2011. FPMRS accounted for 56.7% of prolapse, 62.9% VVF, 59.0% mesh/graft revisions, and 41.9% of incontinence surgeries, compared to female specialists before 2011 (39.1%, 42.4%, 41.5%, and 21.6% respectively (all P < 0.001)). Conclusions: A growing proportion of female urologic cases are performed by female subspecialists, with a significant increase since initiation of FPMRS subspecialty certification. Women surgeons account for a disproportionate volume of these cases despite remaining a minority of certifying urologists and female subspecialists. Neurourol. Urodynam. 36:399–403, 2017.

AB - Aims: To examine surgical case volume characteristics in certifying urologists associated with common female urologic procedures to evaluate the practice patterns, given the recent establishment of subspecialty certification in Female Pelvic Medicine and Reconstructive Surgery (FPMRS) and changes in urologist gender composition. Methods: Six-month case log data of certifying urologists (2003–2013) was obtained from the American Board of Urology (ABU). We examined case logs for 26 CPT codes for common female urologic procedures focused on four procedure groups: incontinence, prolapse, vesicovaginal fistula (VVF), and revision/removal of vaginal mesh/graft. Results: Among 4802 urologists logging at least one female urology case, 43,949 (55.6% of all cases) incontinence, 30,983 (39.2%) prolapse, 451 (0.6%) VVF, and 3643 (4.6%) revision of mesh/graft surgeries were identified. While 90.8% logging at least one female CPT code were men, women surgeons (9.2%) accounted for a disproportionate volume (22.6%) of cases. With initiation of the FPMRS subspecialty certification in 2011, 225 FPMRS candidates (out of 1716 certifying urologists) were identified, compared to 367 (out of 3828 certifying urologists) female subspecialists prior to 2011. FPMRS accounted for 56.7% of prolapse, 62.9% VVF, 59.0% mesh/graft revisions, and 41.9% of incontinence surgeries, compared to female specialists before 2011 (39.1%, 42.4%, 41.5%, and 21.6% respectively (all P < 0.001)). Conclusions: A growing proportion of female urologic cases are performed by female subspecialists, with a significant increase since initiation of FPMRS subspecialty certification. Women surgeons account for a disproportionate volume of these cases despite remaining a minority of certifying urologists and female subspecialists. Neurourol. Urodynam. 36:399–403, 2017.

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