David D. Kim , Max J. Hyman , Parth K. Modi , Emilie K. Johnson
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Two- and five-year secondary procedure rates decreased from 2.90% and 3.62% in 2010 to 2.45% in 2020 and 2.89% in 2017, respectively. Compared to newborn circumcisions performed by obstetrician/gynecologists, the odds of secondary procedure within 2 years were lower for those performed by pediatricians (OR 0.73, 95% CI 0.68-0.78, <em>P</em> <.001), pediatric surgeons (0.57 [0.42–0.76], <em>P</em> <.001), advanced practice clinicians (APC) (0.80 [0.65-0.98], <em>P</em> = .03), and other clinicians (0.67 [0.63-0.71], <em>P</em> <.001). Compared to newborn circumcisions performed by obstetricians/gynecologists, the odds of revision within 2 years were lower for those performed by pediatricians (0.46 [0.42-0.51], <em>P</em> <.001), urologists (0.29 [0.19-0.44], <em>P</em> <.001), pediatric urologists (0.38 [0.22-0.66], <em>P</em> = .001), pediatric surgeons (0.60 [0.36-0.98], <em>P</em> = .04), and other clinicians (0.59 [0.52-0.66], <em>P</em> <.001).</div></div><div><h3>Conclusion</h3><div>Revision rates did not increase over time, and secondary procedure rates slowly declined. Compared to newborn circumcisions performed by obstetrician/gynecologists, the odds of a secondary procedure were either not different or lower for those performed by all other specialties, including APCs, suggesting that newborn circumcision workforce planning should involve training of and collaboration with APCs.</div></div>","PeriodicalId":23415,"journal":{"name":"Urology","volume":"200 ","pages":"Pages 155-162"},"PeriodicalIF":2.0000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Characterization of Newborn Circumcision Revision and Complication Rates Among Privately Insured Boys in the United States Between 2010 and 2022\",\"authors\":\"David D. Kim , Max J. Hyman , Parth K. Modi , Emilie K. Johnson\",\"doi\":\"10.1016/j.urology.2025.02.017\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>To investigate national trends in newborn circumcision complication and secondary procedure rates and whether clinician specialty affects these rates.</div></div><div><h3>Methods</h3><div>The Merative MarketScan Database was queried for claims from 2010 to 2022. CPT 54150 identified newborn circumcisions; CPT 54162, 54163, 54164, 54300, and 54450 identified secondary procedures; ICD-9 and ICD-10 codes identified complications. Multivariable logistic regression was performed to analyze the association between clinician specialty and circumcision revision or secondary procedure.</div></div><div><h3>Results</h3><div>A thirty-day complication was coded for 0.96% of newborns. Two- and five-year secondary procedure rates decreased from 2.90% and 3.62% in 2010 to 2.45% in 2020 and 2.89% in 2017, respectively. Compared to newborn circumcisions performed by obstetrician/gynecologists, the odds of secondary procedure within 2 years were lower for those performed by pediatricians (OR 0.73, 95% CI 0.68-0.78, <em>P</em> <.001), pediatric surgeons (0.57 [0.42–0.76], <em>P</em> <.001), advanced practice clinicians (APC) (0.80 [0.65-0.98], <em>P</em> = .03), and other clinicians (0.67 [0.63-0.71], <em>P</em> <.001). Compared to newborn circumcisions performed by obstetricians/gynecologists, the odds of revision within 2 years were lower for those performed by pediatricians (0.46 [0.42-0.51], <em>P</em> <.001), urologists (0.29 [0.19-0.44], <em>P</em> <.001), pediatric urologists (0.38 [0.22-0.66], <em>P</em> = .001), pediatric surgeons (0.60 [0.36-0.98], <em>P</em> = .04), and other clinicians (0.59 [0.52-0.66], <em>P</em> <.001).</div></div><div><h3>Conclusion</h3><div>Revision rates did not increase over time, and secondary procedure rates slowly declined. Compared to newborn circumcisions performed by obstetrician/gynecologists, the odds of a secondary procedure were either not different or lower for those performed by all other specialties, including APCs, suggesting that newborn circumcision workforce planning should involve training of and collaboration with APCs.</div></div>\",\"PeriodicalId\":23415,\"journal\":{\"name\":\"Urology\",\"volume\":\"200 \",\"pages\":\"Pages 155-162\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Urology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0090429525001803\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/2/17 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Urology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0090429525001803","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/17 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：调查全国新生儿包皮环切术并发症和二次手术发生率的趋势，以及临床医生的专业是否影响这些发生率。方法：查询MerativeTM MarketScan®数据库2010 - 2022年的索赔信息。CPT®54150识别新生儿包皮环切；CPT 54162、54163、54164、54300和54450确定了二级程序；ICD-9和ICD-10代码确定了并发症。采用多变量logistic回归分析临床医师专业与包皮环切手术或二次手术之间的关系。结果：0.96%的新生儿出现30天并发症。两年和五年的二次手术率分别从2010年的2.90%和3.62%下降到2020年的2.45%和2017年的2.89%。与由妇产科医生进行的新生儿包皮环切手术相比，由儿科医生进行的新生儿包皮环切手术在两年内进行二次手术的几率较低（OR 0.73, 95% CI 0.68-0.78, p）。结论：翻修率没有随着时间的推移而增加，二次手术率缓慢下降。与由妇产科医生进行的新生儿包皮环切手术相比，由包括apc在内的所有其他专业进行的新生儿包皮环切手术的几率要么没有差异，要么更低，这表明新生儿包皮环切手术的劳动力规划应包括与apc的培训和合作。
Characterization of Newborn Circumcision Revision and Complication Rates Among Privately Insured Boys in the United States Between 2010 and 2022
Objective
To investigate national trends in newborn circumcision complication and secondary procedure rates and whether clinician specialty affects these rates.
Methods
The Merative MarketScan Database was queried for claims from 2010 to 2022. CPT 54150 identified newborn circumcisions; CPT 54162, 54163, 54164, 54300, and 54450 identified secondary procedures; ICD-9 and ICD-10 codes identified complications. Multivariable logistic regression was performed to analyze the association between clinician specialty and circumcision revision or secondary procedure.
Results
A thirty-day complication was coded for 0.96% of newborns. Two- and five-year secondary procedure rates decreased from 2.90% and 3.62% in 2010 to 2.45% in 2020 and 2.89% in 2017, respectively. Compared to newborn circumcisions performed by obstetrician/gynecologists, the odds of secondary procedure within 2 years were lower for those performed by pediatricians (OR 0.73, 95% CI 0.68-0.78, P <.001), pediatric surgeons (0.57 [0.42–0.76], P <.001), advanced practice clinicians (APC) (0.80 [0.65-0.98], P = .03), and other clinicians (0.67 [0.63-0.71], P <.001). Compared to newborn circumcisions performed by obstetricians/gynecologists, the odds of revision within 2 years were lower for those performed by pediatricians (0.46 [0.42-0.51], P <.001), urologists (0.29 [0.19-0.44], P <.001), pediatric urologists (0.38 [0.22-0.66], P = .001), pediatric surgeons (0.60 [0.36-0.98], P = .04), and other clinicians (0.59 [0.52-0.66], P <.001).
Conclusion
Revision rates did not increase over time, and secondary procedure rates slowly declined. Compared to newborn circumcisions performed by obstetrician/gynecologists, the odds of a secondary procedure were either not different or lower for those performed by all other specialties, including APCs, suggesting that newborn circumcision workforce planning should involve training of and collaboration with APCs.
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.
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