Journal article
Increasing Utilization of Sedation for Prostate Biopsies: National Trends, Predictors, and Patient Cost
Urology (Ridgewood, N.J.), v 205, pp 112-118
01 Nov 2025
PMID: 40683567
Featured in Collection : UN Sustainable Development Goals @ Drexel
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 magnetic resonance imaging (MRI) use were determined through current procedural terminology/International Classification of Diseases 10th revision 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 9 times more likely to involve sedation than systematic biopsies (OR = 9.02, 98% CI = 8.18-9.95, P <.001). Patients with a prior biopsy were 39% more likely to receive sedation (OR = 1.39, 98% CI = 1.35-1.43, P <.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 <.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 and 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.
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Details
- Title
- Increasing Utilization of Sedation for Prostate Biopsies: National Trends, Predictors, and Patient Cost
- Creators
- Camilo Arenas-Gallo - University Hospitals of ClevelandMollie Goldman - Drexel UniversityJack C. Millot - University Hospitals of ClevelandJacob McCann - University Hospitals of ClevelandAnyull D. Bohorquez-Caballero - University Hospitals of ClevelandStephen Rhodes - University Hospitals of ClevelandVishu Chandrasekhar - University Hospitals of ClevelandMichael Callegari - Lahey Medical CenterLeo Puhalla - Northeast Ohio Medical UniversityAdam Calaway - University Hospitals of ClevelandRandy Vince - University Hospitals of ClevelandAdithya Balasubramanian - NewYork–Presbyterian HospitalJim Hu - NewYork–Presbyterian HospitalBashir Al Hussein Al Awamlh - Weill Cornell MedicineSpyridon P. Basourakos - Mayo ClinicLee Ponsky - University Hospitals of ClevelandJonathan E. Shoag (Corresponding Author) - Cornell University
- Publication Details
- Urology (Ridgewood, N.J.), v 205, pp 112-118
- Publisher
- Elsevier
- Number of pages
- 7
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:001620370500020
- Scopus ID
- 2-s2.0-105012849779
- Other Identifier
- 991022197315704721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Urology & Nephrology