{
  "abstract": "OBJECTIVE: To examine population-based trends in utilization of minimally invasive therapies (MITs) for overactive bladder (OAB) stratified by age and frailty among Medicare beneficiaries. METHODS: This population-based study used a 20% sample of fee-for-service Medicare beneficiaries to investigate rates of utilization for MIT for OAB [onabotulinumtoxinA injections (BTX), percutaneous tibial nerve stimulation (PTNS), and sacral neuromodulation (SNM)] from 2015 to 2020. Adjusted incidence rates of each MIT were further stratified by age and frailty, measured by the Claims-based Frailty Index (CFI), using multivariable logistic regression. RESULTS: Among 5,944,458 beneficiaries, 39,211 (0.7%) underwent an MIT for OAB during the study period. Overall adjusted incidence increased from 141.2 per 100,000 in 2015-159.3 per 100,000 in 2019 (a 13% relative increase), driven largely by BTX (40% relative increase). Incidence decreased across all MITs in 2020. Among beneficiaries aged 66-84, greater levels of frailty were associated with higher use of all 3 therapies. However, this association was not observed in beneficiaries over age 85, where rates of use were uniformly low regardless of frailty status. CONCLUSION: Use of MITs for OAB increased from 2015 to 2019, mainly driven by increases in BTX. For all 3 types of MITs, greater levels of frailty were associated with increased utilization among beneficiaries <85 years, regardless of age, while rates for all 3 procedures were low regardless of frailty for beneficiaries ≥85, indicating that utilization of these procedures is driven more by age than frailty in the oldest age group. Further research is needed to determine the factors which influence MIT utilization rates.",
  "abstract_shown": true,
  "affiliations": [
    "University of California, Davis School of Medicine, 4610 X Street, Sacramento, CA 95817, USA",
    "Department of Biostatistics and Epidemiology, University of California, San Francisco, 550 16th Street, San Francisco, CA 94143, USA",
    "Department of Obstetrics and Gynecology, University of California, San Francisco, 550 16th Street, San Francisco, CA 94143, USA",
    "Department of Urology, Weill Cornell School of Medicine, 525 East 68th Street, New York, NY 10065, USA",
    "Department of Obstetrics and Gynecology, University of Virginia, 1215 Lee Street, Charlottesville, VA 22908, USA",
    "Division of Geriatrics, Department of Medicine, University of California, San Francisco, 490 Illinois Street, San Francisco, CA 94143, USA",
    "Department of Urology, University of California, San Francisco, 400 Parnassus Avenue, San Francisco, CA 94143, USA"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
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        0
      ],
      "name": "Adam Crow",
      "orcid": "0009-0001-9625-4739"
    },
    {
      "affs": [
        1
      ],
      "name": "Lufan Wang"
    },
    {
      "affs": [
        2
      ],
      "name": "Abigail Shatkin-Margolis"
    },
    {
      "affs": [
        3
      ],
      "name": "Unwanaobong Nseyo"
    },
    {
      "affs": [
        4
      ],
      "name": "Stephanie W. Zuo"
    },
    {
      "affs": [
        1
      ],
      "name": "W. John Boscardin"
    },
    {
      "affs": [
        5
      ],
      "name": "Ken Covinsky"
    },
    {
      "affs": [
        6
      ],
      "name": "Anne M. Suskind"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2p3dfqt68j3dr.bib",
  "cited_by": 0,
  "doi": "10.1016/j.urology.2026.09.014",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13712920/",
  "id": "2p3dfqt68j3dr",
  "issns": [
    "0090-4295",
    "1527-9995"
  ],
  "landing_url": "https://doi.org/10.1016/j.urology.2026.09.014",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Article"
    ],
    [
      "openalex",
      "2748|Urinary Bladder and Prostate Research"
    ]
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  "openalex": "W7213557296",
  "pdf_url": "https://www.goldjournal.net/article/S0090-4295(26)00588-1/pdf",
  "pmcid": "PMC13712920",
  "pmid": "42759772",
  "published": "2026-09-18",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/2p3dfqt68j3dr.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:23:24Z",
      "native_id": "PMC13712920",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.urology.2026.09.014"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2748|Urinary Bladder and Prostate Research",
      "subfield": "general"
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  ],
  "title": "Trends in the utilization of minimally invasive therapies for overactive bladder among older adults: a national Medicare study",
  "title_text": "Trends in the utilization of minimally invasive therapies for overactive bladder among older adults: a national Medicare study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:23:24Z",
  "url": "https://research.draconitic.com/paper/2p3dfqt68j3dr",
  "venue": "Urology",
  "versions": []
}