Trends in surgical management and pre-operative urodynamics in female medicare beneficiaries with mixed XXXX .

@entity1 @entity1191 @entity322
OBJECTIVE: We sought to examine the surgical trends and utilization of treatment for mixed @entity322 among female Medicare beneficiaries. METHODS: Data was obtained from a 5% national random sample of outpatient and carrier claims from 2000 to 2011. Included were female @entity1 65 and older, diagnosed with mixed @entity322 , who underwent surgical treatment identified by Current Procedural Terminology, Fourth Edition ( @entity1191 -4) codes. Urodynamics (UDS) before initial and secondary procedure were also identified using CPT-4 codes. Procedural trends and utilization of UDS were analyzed. RESULTS: Utilization of UDS increased during the study period, from 38.4% to 74.0% prior to initial surgical intervention, and from 28.6% to 62.5% preceding re-intervention. Sling surgery (63.0%) and injectable bulking agents (28.0%) were the most common surgical treatments adopted, followed by sacral nerve stimulation (SNS) (4.8%) and Burch (4.0%) procedures. Re-intervention was performed in 4.0% of @entity1 initially treated with sling procedures and 21.3% of @entity1 treated with bulking agents, the majority of whom (51.7% and 76.3%, respectively) underwent injection of a bulking agent. Risk of re-intervention was not different among those who did or did not receive urodynamic tests prior to the initial procedure (8.5% vs. 9.3%) CONCLUSIONS: Sling and bulk agents are the most common treatment for MUI. Preoperative urodynamic testing was not related to risk of re-intervention following surgery for mixed @entity322 in this cohort. Neurourol. Urodynam.    2015 Wiley Periodicals, Inc.
