1 in 6 Elderly Switch MIT for OAB Within 2 Years

Background: Overactive bladder (OAB) affects >30% of adults aged ≥65 years and often requires minimally invasive therapies (MITs)—percutaneous tibial nerve stimulation (PTNS), onabotulinumtoxinA (Botox), and sacral neuromodulation (SNM). While MITs are widely used, little is known about the frequency and patterns of initiating >1 MITs in older adults. Objective: To explore trends in the frequency of initiating different minimally invasive OAB therapies in older adults. Design: Retrospective cohort study. Methods: 111,939 fee-for-service Medicare beneficiaries who underwent MIT from 2015 to 2020 were included. Patients with neurogenic bladder and prior MIT were excluded. Primary outcome was initiation of a different MIT within 2 years of the index therapy. Multivariable modified Poisson regression identified factors associated with switching therapies. Results: 18,444 beneficiaries (16.5%) initiated a different MIT within 2 years. PTNS was the most common index therapy among more...