Presentation (CTI)

OBJECTIVES: Evidence describing seasonal variation in urologic care is limited. Understanding these dynamics may offer insights into planning and access to timely urologic care. This study examined seasonal trends across key urologic procedures in a large commercially insured population in the U.S.
METHODS: The 2013-2023 Merative™ MarketScan® Commercial Database was analyzed. Adults aged ≥18 years contributed approximately 120 million beneficiary-years and 8.5 million urologic procedures. Monthly utilization of elective (artificial urinary sphincter [AUS], inflatable penile prosthesis [IPP], slings, sacral neuromodulation [SNM]), semi-elective (lithotripsy, transurethral resection of the prostate [TURP]), and non-elective (ureteral stents, diagnostic ureteroscopy) procedures were assessed. Procedure counts were normalized per 100,000 enrolled beneficiaries. Utilization rates were calculated by pooling the same calendar months across years. Ordinary least squares regression compared each month with January (reference). Coefficients represent differences in monthly procedures per 100,000 beneficiaries, with 95% confidence intervals (CIs).
RESULTS: Seasonal variation differed by procedural urgency. Among elective procedures, sling showed the strongest seasonality, peaking in December with 2.4 additional procedures per 100,000 beneficiaries per month relative to January (β = 2.43, 95% CI 2.11-2.75). SNM increased in late-year months, while AUS and IPP remained stable, with December increases. Semi-elective procedures exhibited spring-summer seasonality, with lithotripsy peaking in August (0.8 additional procedures per 100,000 beneficiaries per month, β = 0.77, 95% CI 0.56-0.98); TURP showed smaller later-year increases. Non-elective procedures demonstrated minimal seasonal variation; diagnostic ureteroscopy increased modestly in early summer, peaking in June (0.25 additional procedures, β = 0.25, 95% CI 0.07-0.42), while ureteral stent utilization remained stable.
CONCLUSIONS: Seasonal variation differed by procedural urgency, with late-year increases in elective procedures, spring-summer peaks in semi-elective procedures, and limited variation in non-elective procedures. Recognizing these consistent temporal trends may support more effective demand forecasting, resource allocation, and care coordination, helping practices maintain timely access across urologic services.