Study design, materials and methods
The electronic medical records and billing data was queried to extract the number of bladder augmentations and BTX-A injections done each year for the last 11 years at a single academic center. Study included patients greater then 18 years of age who had an office visit with a urology provider from 1/1/2007 to 1/1/2018 and had a diagnosis of neurogenic bladder. Bladder augmentation procedures were identified by CPT codes 51960, 51800 and BTX-A injection procedures were identified by CPT 52287, 53899.1, 52327, 52214 codes. Total number of patient visits per year with neurogenic bladder diagnoses seen by urology providers was used to adjust for the increasing volume of patients evaluated.
Interpretation of results
The raw number of bladder augmentations per year has remained constant over the last 11 years but the rate of bladder augmentation per neurogenic bladder patient encounter has declined dramatically at a single institution. The number and rate of BTX-A use for patients with neurogenic bladder has increased since its approval in 2011 indicating a shift in management algorithm in patients with neurogenic bladder.