Prescribing Trends for Vaginal Estrogen: What Role Do Urogynecology and Reconstructive Pelvic Surgery Urologists Play? - 28/10/25

Doi : 10.1016/j.urology.2025.10.013

Derek Tran ^a,^⁎ , Jared Faith ^b, Robert Chang ^c, Alexandra L. Tabakin ^d, Wai Lee ^e
^a Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY
^b Department of Urology, University of California Los Angeles, Los Angeles, CA
^c Department of Urology, Hackensack University Medical Center, Hackensack, NJ
^d Department of Urology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
^e Department of Urology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY

^⁎Address correspondence to: Derek Tran, BS, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.Donald and Barbara Zucker School of Medicine at Hofstra/NorthwellHempsteadNY

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Tuesday 28 October 2025

ABSTRACT

Objective

To evaluate the impact of Urogynecology and Reconstructive Pelvic Surgery (URPS) board certification on prescribing trends of vaginal estrogen (VE) by urologists participating in Medicare Part D.

Methods

The Medicare Part D Prescriber dataset was queried from 2016 to 2018 to identify urologists who made VE claims. Board certification status was obtained from the American Board of Urology website. Urologist gender was obtained from the National Plan & Provider Enumeration System NPI registry. Parametric statistics were used to analyze claims and expenditure trends.

Results

From 2016 to 2018, 2367 urologists were identified with VE claims, including 272 board-certified in URPS. URPS urologists had more claims per prescriber than non-URPS urologists for all years (2016: 42.9 vs 26.7, P <.01; 2017: 42 vs 27.4, P <.01; 2018: 30.1 vs 23.9, P <.01). Female urologists had more claims per prescriber than male urologists in 2016 (36.9 vs 26.5, P <.01) and 2017 (37.9 vs 26.8, P <.01). On multivariate analysis, URPS fellowship (β = 8.6, 95% CI 6.3-10.8, P <.01) and female gender of prescriber (β = 4.9, 95% CI 3.1-6.7, P <.01) were significant predictors for making more VE claims. Within URPS urologists, there was no significant difference in average VE claims between male and female prescribers.

Conclusion

Both URPS and female urologists made more VE claims per prescriber than non-URPS urologists. These findings may reflect referral patterns or reveal discrepancies in how urologists treat genitourinary syndrome of menopause.