Camilo Arenas-Gallo, Mollie Goldman, Jack C Millot, Jacob McCann, Anyull D Bohorquez-Caballero, Stephen Rhodes, Vishu Chandrasekhar, Michael Callegari, Leo Puhalla, Adam Calaway, Randy Vince, Adithya Balasubramanian, Jim Hu, Bashir Al Hussein Al Awamlh, Spyridon P Basourakos, Lee Ponsky, Jonathan E Shoag
{"title":"Increasing Utilization of Sedation for Prostate Biopsies: National Trends, Predictors, and Patient Cost.","authors":"Camilo Arenas-Gallo, Mollie Goldman, Jack C Millot, Jacob McCann, Anyull D Bohorquez-Caballero, Stephen Rhodes, Vishu Chandrasekhar, Michael Callegari, Leo Puhalla, Adam Calaway, Randy Vince, Adithya Balasubramanian, Jim Hu, Bashir Al Hussein Al Awamlh, Spyridon P Basourakos, Lee Ponsky, Jonathan E Shoag","doi":"10.1016/j.urology.2025.07.022","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To describe national trends, predictors, insurance and patient costs associated with sedation use during prostate biopsies.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the Merative Marketscan Database from 2016 to 2021. Men undergoing prostate biopsy were identified using CPT codes. Biopsy type, anesthesia claims, comorbidities, and MRI use were determined through CPT/ICD-10 codes. Multivariable logistic regression assessed predictors of sedation use. Out-of-pocket costs were calculated by summing insurance copays, deductibles, and coinsurance, adjusted to 2021 dollars.</p><p><strong>Results: </strong>The final cohort included 172,148 prostate biopsies. The mean patient age was 62 ± 8 years. The proportion of biopsies performed with sedation increased from 15.6% in 2016 to 25.5% in 2021. Saturation biopsies were nine times more likely to involve sedation than systematic biopsies (OR= 9.02, 98% CI= 8.18-9.95, p<0.001). Patients with a prior biopsy were 39% more likely to receive sedation (OR= 1.39, 98% CI= 1.35-1.43, p<0.001). MRI-guided biopsies were nearly twice as likely to involve sedation compared to non-MRI biopsies (OR= 1.98, 98% CI= 1.93-2.04, p<0.001). In 2021, the expected out-of-pocket cost for sedated biopsies was $663 USD (98% CI= $644-$682), compared to $489 USD (98% CI= $479-$498) for non-sedated procedures.</p><p><strong>Conclusion: </strong>Sedation use during prostate biopsies is steadily increasing, alongside associated patient costs. Patients undergoing saturation biopsies, MRI-guided procedures, and those with prior biopsy history were more likely to receive sedation. These findings highlight evolving patterns in biopsy practices and underscore the need to balance patient comfort with procedural cost and accessibility considerations.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Urology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.urology.2025.07.022","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To describe national trends, predictors, insurance and patient costs associated with sedation use during prostate biopsies.
Methods: We conducted a retrospective cohort study using the Merative Marketscan Database from 2016 to 2021. Men undergoing prostate biopsy were identified using CPT codes. Biopsy type, anesthesia claims, comorbidities, and MRI use were determined through CPT/ICD-10 codes. Multivariable logistic regression assessed predictors of sedation use. Out-of-pocket costs were calculated by summing insurance copays, deductibles, and coinsurance, adjusted to 2021 dollars.
Results: The final cohort included 172,148 prostate biopsies. The mean patient age was 62 ± 8 years. The proportion of biopsies performed with sedation increased from 15.6% in 2016 to 25.5% in 2021. Saturation biopsies were nine times more likely to involve sedation than systematic biopsies (OR= 9.02, 98% CI= 8.18-9.95, p<0.001). Patients with a prior biopsy were 39% more likely to receive sedation (OR= 1.39, 98% CI= 1.35-1.43, p<0.001). MRI-guided biopsies were nearly twice as likely to involve sedation compared to non-MRI biopsies (OR= 1.98, 98% CI= 1.93-2.04, p<0.001). In 2021, the expected out-of-pocket cost for sedated biopsies was $663 USD (98% CI= $644-$682), compared to $489 USD (98% CI= $479-$498) for non-sedated procedures.
Conclusion: Sedation use during prostate biopsies is steadily increasing, alongside associated patient costs. Patients undergoing saturation biopsies, MRI-guided procedures, and those with prior biopsy history were more likely to receive sedation. These findings highlight evolving patterns in biopsy practices and underscore the need to balance patient comfort with procedural cost and accessibility considerations.
期刊介绍:
Urology is a monthly, peer–reviewed journal primarily for urologists, residents, interns, nephrologists, and other specialists interested in urology
The mission of Urology®, the "Gold Journal," is to provide practical, timely, and relevant clinical and basic science information to physicians and researchers practicing the art of urology worldwide. Urology® publishes original articles relating to adult and pediatric clinical urology as well as to clinical and basic science research. Topics in Urology® include pediatrics, surgical oncology, radiology, pathology, erectile dysfunction, infertility, incontinence, transplantation, endourology, andrology, female urology, reconstructive surgery, and medical oncology, as well as relevant basic science issues. Special features include rapid communication of important timely issues, surgeon''s workshops, interesting case reports, surgical techniques, clinical and basic science review articles, guest editorials, letters to the editor, book reviews, and historical articles in urology.