Evidence map›Paper›PMID 41229179›Full record

ArticleNeurourology and urodynamics2026

Utilization of More Than One Minimally Invasive Overactive Bladder Therapy Among Older Adults; a National Medicare Study.

Abigail Shatkin-Margolis, Adam Crow, Lufan Wang, Unwanaobong Nseyo, Louise Walter, Kenneth Covinsky, W John Boscardin, Anne M Suskind

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurourology and urodynamics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Abigail Shatkin-MargolisDepartment of Obstetrics and Gynecology, University of California, San Francisco, California, USA.
Adam CrowUniversity of California Davis School of Medicine, Sacramento, California, USA.
Lufan WangDepartment of Urology, University of California, San Francisco, California, USA.
Unwanaobong NseyoDepartment of Urology, Weill Cornell Medical Center, New York, New York, USA.ORCID https://orcid.org/0000-0001-7521-7827
Louise WalterDivision of Geriatrics, University of California, San Francisco, California, USA.
Kenneth CovinskyDivision of Geriatrics, University of California, San Francisco, California, USA.
W John BoscardinDepartment of Epidemiology and Biostatistics, University of California, San Francisco, California, USA.
Anne M SuskindDepartment of Obstetrics and Gynecology, University of California, San Francisco, California, USA.ORCID https://orcid.org/0000-0002-8437-3861

Funding

UCSF-Kaiser Urological Epidemiology Research Career Development ProgramK12DK111028 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI HUANG, ALISON · 2016 to 2025
$5.3M
Risk determination and prognostication for older and frail older adults undergoing advanced treatments for overactive bladderR01AG082642 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Anne M. Suskind · 2024 to 2026
$1.3M
Determinants of outcomes for older and frail older adults with refractory overactive bladderR56AG076501 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SUSKIND, ANNE M. · 2023 to 2023
$474k
NIA NIH HHS R01 AG082642NIA NIH HHS R56 AG076501NIDDK NIH HHS K12 DK111028Research reported in this publication was supported by grant 1K12DK111028 from the National Institute of Diabetes, Digestive, and Kidney Disorders and grant R01AG082642 from the National Institute of Aging.
6 · The paper itself

Abstract

aimsMinimally invasive overactive bladder (OAB) therapies (percutaneous tibial nerve stimulation [PTNS], onabotulinumtoxinA [BTX], sacral neuromodulation [SNM]) are commonly used in older adults, however little is known regarding utilization of more than one minimally invasive OAB therapy within 2 years of initiating such treatment.

methodsThis retrospective cohort study included 100% of fee-for-service Medicare beneficiaries who underwent minimally invasive OAB therapy (MIT) from 2015 to 2020. The primary outcome was initiation of a different MIT within 2 years of the index therapy. A Sankey diagram was created to visualize the sequence and flow of therapies. Multivariable modified Poisson regression was performed to identify patient-factors associated with initiating different MIT.

resultsAmong the 111,939 beneficiaries undergoing first-time MIT, 18,444 (16.5%) initiated different MIT within 2 years. The most common pattern was PTNS followed by BTX (29.1%), then BTX followed by SNM (20.9%) and SNM followed by BTX (20.0%). Factors associated with increased likelihood of initiating different MIT were: PTNS as the index therapy (aRR 1.43, 95% CI 1.38-1.48 vs. SNM), female sex (aRR 1.12, 95% CI 1.09-1.16), and higher frailty levels (pre-frail aRR 1.09, 95% CI 1.06-1.13; mild-to-severe frailty aRR 1.08, 95% CI 1.03-1.14 vs. not frail). Older age (75-84 aRR 0.88, 95% CI 0.86-0.91; ≥ 85 aRR 0.60, 95% CI 0.57-0.63 vs. 65-74 years) and non-White race (aRR 0.79, 95% CI 0.75-0.84) were associated with lower likelihood of initiating different MIT.

conclusionAmong Medicare beneficiaries receiving MIT, 16.5% initiated different therapy within 2 years. These high rates of more than one MIT within a short time endorse the need for expectation-setting and close follow-up.

Indexed as

Electric Stimulation TherapyTranscutaneous Electric Nerve StimulationUrinary Bladder, OveractiveAgedAged, 80 and overBotulinum Toxins, Type AFemaleHumansMaleMedicareRetrospective StudiesTibial NerveTreatment OutcomeUnited StatesBotulinum Toxins, Type Aonabotulinum toxin A

Identifiers

PMID41229179
PMCPMC12815470

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.