Minimally Invasive Overactive Bladder Therapy After Prolapse Surgery.

Area of Science:

• Urogynecology
• Geriatric Medicine
• Health Services Research

Background:

• Pelvic organ prolapse (POP) and overactive bladder (OAB) frequently coexist in older women.
• Understanding treatment patterns for OAB following POP surgery is crucial for optimizing patient care.

Purpose of the Study:

• To investigate the utilization of minimally invasive OAB therapies in older women after undergoing POP surgery.
• To identify factors associated with the use of these therapies.

Main Methods:

• Retrospective cohort study of Medicare beneficiaries undergoing POP surgery (2014-2015).
• Primary outcome: new minimally invasive OAB therapy use within 2 years.
• Secondary outcome: new OAB diagnosis.
• Analysis included modified Poisson regression to determine relative risks.

Main Results:

• 1.9% of 58,841 women received minimally invasive OAB therapy post-surgery.
• 9.2% developed a new OAB diagnosis within 2 years.
• Factors increasing therapy use included apical POP surgery, concomitant stress urinary incontinence surgery, pre-existing OAB, and frailty.

Conclusions:

• Rates of minimally invasive OAB therapy are low in older women post-POP surgery.
• A significant proportion of women develop new OAB diagnoses after surgery.
• Further research is needed to understand and improve OAB management in this population.