Interventional radiologists taking hold of genitourinary procedure market, performing 90% of surgeries

The number of minimally invasive urologic procedures has grown consistently over recent years and interventional radiologists are performing the lion’s share, according to a new analysis of nationwide data published Wednesday.

In fact, the volume of tube-related genitourinary procedures—such as ureteral stent and nephrostomy tube placements—jumped by 33.4% between 2005 and 2015. And interventionalists have solidified their role in these exams, performing about 90% overall, with a few exceptions.

There’s been little insight into which specialties are dominant in this market, but these national trends can inform future healthcare spending, clinical practice guidelines and medical education planning, first author Elizabeth von Ende, DO, and co-authors explained in JACR.

“Despite the rapid growth in these procedures, interventional radiologists continue to perform the majority … often treating patients with more comorbidities,” von Ende, a radiologist at Ohio State University Wexner Medical Center, and colleagues added. “These findings demonstrate the value of radiology regarding tube-related genitourinary procedures and their performance of these procedures on a sicker patient population.”

Their findings are based on a 5% sample of Medicare claims data over a 10-year study period. Nine billable genitourinary interventions were analyzed to determine trends, and the Charleston Comorbidity Index—based on 17 comorbidities—was used to assess differences between patient populations.

Tube-related procedure volumes rose from 455 services per 100,000 fee-for-service beneficiaries in 2005 to 607.2 services in 2015, a 33.4% increase. Interventional rads led upwards of 90% of these procedures in each year, with two exceptions: Urologists performed about 85% of nephro-ureteral catheter and ureteral stent placements.

Furthermore, IR docs more often worked on patients with comorbidities compared to urologists. Imaging providers performed 63% of their overall procedures on such patients, compared to 42% for urologists.

“Overall, this demonstrates the value of radiologists in performing these procedures on patients with a higher number of comorbidities,” the authors concluded. “We speculate radiologists often receive referrals for more challenging cases due to their expertise and command of imaging guidance.”

You can read the entire article in the Journal of the American College of Radiology.

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