Baunacke Martin, Groeben Christer, Borkowetz Angelika, Uhlig Annemarie, Leitsmann Marianne, Volkmer Björn, Thomas Christian, Huber Johannes
Klinik und Poliklinik für Urologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland.
Klinik für Urologie, Universitätsmedizin Göttingen, Georg-August-Universität, Göttingen, Deutschland.
Urologe A. 2021 Mar;60(3):351-360. doi: 10.1007/s00120-021-01444-5. Epub 2021 Jan 22.
Treating urinary incontinence and erectile dysfunction improves quality of life for many patients. In particular, sphincter and penile prostheses achieve very good results when conservative therapy options are exhausted. The aim of this study is to present the development and current state of sphincter and penile prosthesis implantation in Germany.
We carried out an analysis of the Diagnosis Related Groups billing data in Germany from 2006-2016. We described the state of care in 2016 based on the German hospitals' quality reports.
Between 2006 and 2012 implantations of sphincter prostheses in Germany increased from 739 to 1112 (p < 0.001), the amount of implanting hospitals also increased from 129 to 206 (p < 0.001). From 2012-2016, the number of cases decreased to 980 and the number of hospitals to 198. In 2016, 168 (88%) urological hospitals implanted 1-9 sphincter prostheses and 23 (12%) hospitals implanted ≥ 10 sphincter prostheses. The top 10 hospitals (≥20 sphincters) implanted 34% (283/839) of all sphincters. Between 2006 and 2013 the number of implanted penile prostheses continuously increased from 263 to 503 (p < 0.001), the number of implanting hospitals from 71 to 107 (p < 0.001). From 2013-2016, the number of cases (p = 0.9) and the number of implanting hospitals (p = 0.5) stagnated. The proportion of penile prostheses implanted as part of gender reassignment surgery increased from 17% in 2006 to 25% in 2016 (p = 0.03). In 2016, 83 (85%) urological hospitals implanted 1-6 penile prostheses and 14 (15%) hospitals implanted ≥ 7 prostheses. The 7 top hospitals (≥20 prostheses/year) implanted 232/448 (52%) of the prostheses.
The current state of urological endoprosthetics in Germany shows a small number of high-volume centers, but also a large number of hospitals with a small number of cases. Since 2012/2013, there has been a stagnation in the number of cases of penile and sphincter prosthesis implantations. In view of the number of radical prostatectomy cases, this development suggests an undersupply.
治疗尿失禁和勃起功能障碍可改善许多患者的生活质量。特别是，当保守治疗方法用尽时，括约肌和阴茎假体可取得非常好的效果。本研究的目的是介绍德国括约肌和阴茎假体植入术的发展情况和现状。
我们对2006 - 2016年德国诊断相关分组计费数据进行了分析。我们根据德国医院的质量报告描述了2016年的护理状况。
2006年至2012年期间，德国括约肌假体植入数量从739例增加到1112例（p<0.001），植入医院数量也从129家增加到206家（p<0.001）。2012年至2016年，病例数降至980例，医院数降至198家。2016年，168家（88%）泌尿外科医院植入了1 - 9个括约肌假体，23家（12%）医院植入了≥10个括约肌假体。排名前10的医院（≥20个括约肌）植入了所有括约肌的34%（283/839）。2006年至2013年期间，阴茎假体植入数量从263例持续增加到503例（p<0.001），植入医院数量从71家增加到107家（p<0.001）。2013年至2016年，病例数（p = 0.9）和植入医院数量（p = 0.5）停滞不前。作为性别重置手术一部分植入的阴茎假体比例从2006年的17%增加到2016年的25%（p = 0.03）。2016年，83家（85%）泌尿外科医院植入了1 - 6个阴茎假体，14家（15%）医院植入了≥7个假体。排名前7的医院（≥20个假体/年）植入了232/448（52%）的假体。
德国泌尿外科腔内假体的现状显示，有少数高容量中心，但也有大量病例数少的医院。自2012/2013年以来，阴茎和括约肌假体植入病例数停滞不前。鉴于根治性前列腺切除术的病例数，这一发展表明供应不足。
