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Voiding Dysfunction Among Older Adults With Non-Muscle Invasive Bladder Cancer: Incidence and Predictors of Treatment
Boris Gershman1, Agustin Perez-Londono1, Jamil Almohtasib1
1Division of Urologic Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
Neurourology and Urodynamics
|March 19, 2026
Summary
Overactive bladder (OAB) treatment is common in older adults with non-muscle invasive bladder cancer (NMIBC). Female gender, heart failure, and T1 tumor stage predict OAB treatment needs.
Area of Science:
- Urology
- Geriatrics
- Oncology
Background:
- Non-muscle invasive bladder cancer (NMIBC) presents a significant lifelong treatment burden and can lead to urinary morbidity.
- Quality-of-life impacts, particularly overactive bladder (OAB), are understudied in this patient population.
Purpose of the Study:
- To evaluate the incidence of OAB treatment among older adults diagnosed with NMIBC.
- To identify predictors associated with the need for OAB treatment following NMIBC diagnosis.
Main Methods:
- Analysis of adults aged 66-89 with newly diagnosed NMIBC (2007-2017) from the SEER-Medicare database.
- Examination of OAB treatment initiation post-initial transurethral resection of bladder tumor (TURBT).
- Cox regression analysis to assess associations with baseline characteristics.
Main Results:
- By 5 years post-TURBT, 15% of NMIBC patients initiated OAB treatment.
- Anticholinergic medications and beta-3 agonists were the most common OAB therapies.
- Female gender, congestive heart failure, and T1 tumor stage were independently associated with increased OAB treatment risk.
Conclusions:
- A substantial proportion of NMIBC patients require OAB treatment, with incidence reaching 15% by 5 years.
- Predictive factors like sex, high-risk tumor features, and repeat TURBT can aid clinical counseling for OAB management.
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