Studies from Brown University Warren Alpert Medical School Further Understanding of Managed Care (Lack of Diversity in Minimally Invasive Bladder Outlet Surgery Among Urologists in the United States): Managed Care

2025 NOV 07 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Current study results on Managed Care have been published. According to news reporting originating in Providence, Rhode Island, by NewsRx journalists, research stated, “New bladder outlet procedures have been introduced in the last decade, but there has been limited research into procedural uptake and diversification at provider and regional levels. In this study, we investigated trends in these procedures within Medicare over a six-year period.”

The news reporters obtained a quote from the research from Brown University Warren Alpert Medical School, “We hypothesized that provider age and rurality would be associated with procedural diversity. We conducted a retrospective analysis of bladder outlet procedures in Medicare data from 2014 to 2019, including transurethral resection of prostate (TURP), Greenlight laser vaporization (GL), UroLift (UL), Rezum (RZ), and laser enucleation (LEP). Data were analyzed by provider and U.S. census region. Vector autoregressive modeling was used to test the hypothesis that greater procedural diversity would be found in more urban regions with younger providers. In 2019, a sample of 2747 Medicare providers performed bladder outlet surgery nationwide. 81% performed one type of procedure, whereas only one performed more than three types. TURP was favored across all regions. TURP and GL volume decreased while UL increased over the study period; RZ and LEP were less common. Two regions, the Northeast and West, demonstrated significantly greater procedural diversity, but differences could not be attributed to provider age or rurality at the national level. In the regional analysis, however, rural areas with less variation in provider age had slower uptake of newer procedures (p = 0.022), and urban areas with more variation in provider age demonstrated more rapid uptake (p = 0.008). While TURP continues to be the most common bladder outlet procedure, there is steady adoption of new technologies with complex patterns of uptake based on provider age and rurality.”

According to the news reporters, the research concluded: “Understanding the dissemination of new procedures and the appropriate role of procedural diversification may help to improve both access to and quality of care.”

This research has been peer-reviewed.

For more information on this research see: Lack of Diversity in Minimally Invasive Bladder Outlet Surgery Among Urologists in the United States. Rhode Island Medical Journal, 2025;108(11):45-50.

Our news correspondents report that additional information may be obtained by contacting William Connolly, Brown University School of Medicine, Providence, RI. Additional authors for this research include Emma Waddell, Anna Shlimak, Borivoj Golijanin, Joshua Ray Tanzer, Stephen Schmit, Rebecca Ortiz, Andrew Tompkins and Elias Hyams.

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