title: Urinary retention and catheter use among U.S. female Medicare beneficiaries: Prevalence and risk factors.
abstract: OBJECTIVE
  To identify the prevalence of and risk factors for urinary retention and catheterization among female Medicare beneficiaries.
  
  
  METHODS
  We identified women with a diagnosis of urinary retention in a 5% sample of Medicare claims in 2012. Women were categorized into three groups based on the occurrence and duration of urinary catheterization within a 1 year period: 1) no catheterization; 2) short-term catheterization (ie, one or more catheterizations in less than 30 days); and 3) chronic catheterization (catheterizations in multiple 30 day periods within 1 year). We then identified a group of age-matched controls without catheterization or a diagnosis of urinary retention in 2012. Clinical and demographic data were collected for each patient, and risk factors for retention and catheterization were compared across groups. We assessed factors associated with urinary retention using multivariable logistic regression.
  
  
  RESULTS
  We estimated the rate of retention to be 1532 per 100 000 U.S. female Medicare beneficiaries in 2012, with rates of short term and chronic catheterization estimated to be 160 and 108 per 100 000 women, respectively. Prior diagnoses of neurologic condition, urinary tract infection, and pelvic organ prolapse were positively associated with retention and catheterization in multivariable analyses.
  
  
  CONCLUSIONS
  We estimated the prevalence of urinary retention diagnoses among female Medicare beneficiaries to be 1532 per 100 000 women. Retention and catheterization were significantly associated with comorbid disease, with the strongest associations identified with a concomitant diagnosis of neurologic condition, UTI, and POP.
authors.affiliation: Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Joshua A
authors.identifier: http://orcid.org/0000-0002-4953-3321
authors.initials: JA
authors.lastname: Cohn
authors.affiliation: Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Shenghua
authors.initials: S
authors.lastname: Ni
authors.affiliation: Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Melissa R
authors.initials: MR
authors.lastname: Kaufman
authors.affiliation: Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Graves
authors.affiliation: Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: David F
authors.initials: DF
authors.lastname: Penson
authors.affiliation: Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Roger R
authors.initials: RR
authors.lastname: Dmochowski
authors.affiliation: Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: W Stuart
authors.initials: WS
authors.lastname: Reynolds
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D006278:Medicare; D015999:Multivariate Analysis; D009422:Nervous System Diseases / Q000453:epidemiology*; D056887:Pelvic Organ Prolapse / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014546:Urinary Catheterization / Q000706:statistics & numerical data*; D016055:Urinary Retention / Q000453:epidemiology* / Q000628:therapy; D014552:Urinary Tract Infections / Q000453:epidemiology*
keywords: lower urinary tract symptoms; pelvic organ prolapse; underactive bladder; urinary retention