2314 BASELINE URODYNAMIC PARAMETERS DO NOT AFFECT THE TREATMENT OUTCOME OF INTRAVESICAL 100U ONABOTULINUMTOXINA INJECTION FOR PATIENTS WITH IDIOPATHIC DETRUSOR OVERACTIVITY

Abstract

INTRODUCTION AND OBJECTIVES: Intravesical injection of onabotulinumtoxinA (BoNT-A) provides effective treatment for idiopathic detrusor overactivity (IDO). However, not all patients have successful long-term therapeutic effect. This study investigated the affect of baseline urodynamic parameters on the therapeutic effect and adverse events after injecting 100U onabotulinumtoxinA in patients with IDO refractory to antimuscarinics. METHODS: A total of 174 patients who received the first single intravesical BoNT-A 100U injection for refractory IDO were included. The success rate was determined based on patient perception of bladder condition (PPBC) improved by 2 scales. The short-term (3 months) and long-term (up to 24 months) success rates were analyzed according to the baseline urodynamic parameters including cystometric bladder capacity, maximum flow rate, postvoid residual, voiding efficiency, and DO subtypes. The BoNT-A related adverse events were also reported. RESULTS: A successful outcome was reported by 138 (79.3%) patients at 3 months. The baseline urodynamic parameters did not affect the success rates except that patients with phasic DO had a significantly higher success rate at 3 months than patients with terminal DO. Patients with a baseline PVR 100ml had a higher rate of acute urinary retention and needed straining to void. However, long-term success rates upto 24 months showed no significant difference between patients with different urodynamic parameters. CONCLUSIONS: Except for patients with phasic DO, the baseline urodynamic parameters did not affect the treatment outcome of intravesical injection of 100U onabotulinumtoxinA for IDO. However, the occurrence of AUR and difficult urination were significantly greater in patients with baseline PVR of 100ml.