How Urology Service Lines Have Changed Over the Last Decade

It's no secret that urology is evolving: The field's advancement has continued unabated over the past few decades thanks to new diagnostic techniques, technologies, and standards. But what about urology practices themselves?

Practitioners haven't fallen behind as their specialization evolves. Urology practice services have expanded alongside patient demand and novel clinical methodologies. Here's a quick recap of how practices have changed over the past decade.

What Is the Wayback Machine?

We couldn't just ask urologists what differentiates contemporary practices and their service portfolios from past versions. After all, few would likely reveal the secret sauce that makes their business models tick!

Instead, we turned to the Wayback Machine.

The Wayback Machine is a digital archive of the World Wide Web, founded by the Internet Archive, a non-profit organization based in San Francisco. It allows users to go back and see what websites looked like in the past. 

Historians and researchers routinely use the Wayback Machine to recover lost websites and track the web's evolution. This made the tool a perfect candidate for our impromptu survey of urology practice service evolution.

Our Technique for Assessing New Urology Service Lines

This wasn't a formal study – just a quick exercise in gauging industry trends. That said, we did try to approach the problem in an even-handed way.\

Our methodology for this assessment was simple: We selected a few urology practices around the country, choosing those with web presences dating back at least ten years. Then, we used the Wayback Machine to compare their online service offerings then and now.

The Wayback Machine automatically archives public sites and popular web portals – like Google.com or Facebook.com. Other sites typically get indexed in the database after someone manually enters their URLs into the archive's web interface. This means that when researching urology practice offerings, you have to be somewhat selective.

Another important caveat involves frequency. Although it didn't make much difference for this particular assessment, the Wayback Machine doesn't create copies of each website at the same intervals – between the Internet Archive's internal algorithm and the fact that people can initiate snapshots manually, some records may present denser time series data. In other words, if you're looking for a fine-grained market breakdown, you'll need to be even more judicious about choosing your candidates. 

We had to do some digging to glean quality insights from this kind of research. Most practices change their website contents and layouts periodically, so it's not always possible to compare them one-to-one. Also, the Internet Archive doesn't record certain types of digital content, like videos and embedded media, so these wouldn't be good sources of insight. 

In some cases, the Wayback Machine also archives different subpages, such as menus, main portals, and blogs, separately based on how often they're updated by the site owners. The frequency of archive updates doesn't precisely correspond, however, to the frequency of source site updates.

We limited our investigation to four sites and their most relevant textual elements: the urology-related service offering pages and menus in or around 2013 and 2022. The practice sites we picked were:

• https://www.uro.com: Virginia Urology is a 65-provider urologist and urogynecologist network that serves the Greater Richmond, VA, area with seven offices and an ambulatory surgery center. The practice dates back to 1929, and it trains residents from the Virginia Commonwealth University Health System. Wayback Machine archive.
• https://www.urologycentersalabama.com Urology Centers of Alabama is a 27-urologist practice whose staff also includes urogynecologists, radiation oncologists, and pathologists. It has a 70-year history. Wayback Machine archive.
• https://njurology.com New Jersey Urology, a part of Summit Health, operates 56 locations and 7 cancer centers in two states, maintaining a staff of 135 providers. Wayback Machine archive.
• https://www.aucofny.com Advanced Urology Centers of New York serves about 2,000 patients per day in the New York Region, mainly focusing on the area around NYC. It's a division of Integrated Medical Professionals and a Solaris Health affiliate. Wayback Machine archive.

What the Wayback Machine Revealed About Urology Service Lines

We noticed a few interesting trends in urology practice services over ten years:

The Condition Status Quo

Most of the sites we reviewed didn't significantly update the types of conditions they treated. Back in the day, these practices advertised their ability to help patients with problems like urinary incontinence, prostate health, kidney stones, genitourinary cancers, and vasectomies, and they still do. 

Such a finding doesn't mean that the practices we reviewed never modified their domains of expertise – or how they presented themselves. All underwent major digital rebranding and redesign efforts, moving away from long lists of treatable conditions toward better-organized categories.

Another interesting evolution was that the practices seemed to invest more time into service-related patient education. Even though blogs existed way back in the early 2010s, most revolved around announcements, news bulletins, and similar forms of outreach. Today's practices seem more willing to provide helpful pointers, tips, and topical deep dives about specific conditions, studies, and treatments.

The Treatment Difference

When comparing treatments, we found that most urology providers seemed to expand the number of different treatment options they offered online. This wasn't a huge revelation, but it spoke to the fact that practices may be rethinking their marketing outreach. 

Robotic surgery is a prime example of how marketing and other trends might be related. Almost all the practices we checked out performed robotic surgery a decade ago, but most of them focused on a single type – like DaVinci prostatectomies. 

Not only did urologists expand their offerings to include other branded robotic surgeries, but they also switched up the marketing language. For instance, the term “minimally invasive” became increasingly prevalent in procedure descriptions, hinting at a more refined approach to getting patients on board. Another factor might be that robotic surgery is becoming more popular with patients. 

We could draw similar conclusions from the other treatment offerings on practice websites. For instance, no-scalpel vasectomies date back decades, but earlier sites didn't seem to list them as often or explicitly. This could have been due to marketing, patient demand, or some other factor, but it seems like a safe bet that practitioners are trying to capitalize on the trends either way.

We also noticed an expansion in branded surgeries: No longer do DaVinci and InterStim dominate the offerings; providers are advertising a broader variety of treatment options and technologies. Telemedicine also popped up on several sites over the past decade, although we wouldn't be surprised if COVID-19 had something to do with that.

Interestingly, some practices appeared to take pages from their competitors' playbooks. In the early 2010s, only a couple of our sample practices specifically mentioned their cancer treatment regimens. By 2021, almost all explicitly stated that they offered oncological services or conducted clinical cancer research. This could reflect increased public awareness of cancer or organizational changes such as being acquired by a larger health system.

Other new service lines that deserve mentioning that appear on most if not all the sites examined but were not present in the 2012 to 2013 timeframe are:

• Vaginal Rejuvenation and MonaLisa Touch – This is a new aesthetic treatment that has come to market in recent years. Based on Wayback Machine results, it appears MonaLisa Touch did not launch broad commercial efforts until 2015. 
• Axonics Neuromodulation – In 2013, the sites we examined only listed InterStim Neuromodulation, but they now reference both Interstim Neuromodulation and Axonics Neuromodulation.
• Botox Treatment for Incontinence – Since the market adoption of this treatment is relatively new, it makes sense that this would be listed on all sites in recent years.
• UroLift – UroLift is a relatively new treatment for benign prostatic hyperplasia (BPH) and was not available in the 2010 2013 time frame but is broadly offered by larger urology practices now. Using the Wayback Machine, it appears that UroLift only started commercial efforts in late 2013.  

There were other service lines also mentioned, but the ones above were the most common across all the sites. 

Drawing Conclusions

Practice service line portfolios can evolve for many reasons, including the acquisition of new talent or changes in business models – like outsourcing urodynamics services. Also, as individual practices change their offerings, their competitors feel more pressure to follow suit. 

At the same time, the way people browse the web – on phones with smaller screens, in their spare time, and through the lens of sprawling social media sites – means practices must be cautious not to overwhelm users. 

Even if you want to shout about your expansive practice line from the rooftops, it's probably best not to do so too loudly. Instead, you may gain the most mileage by dishing out service info in bite-sized, web-optimized chunks that people can easily consume on their way to becoming patients.