MP74-08 REAL-WORLD CLEAN INTERMITTENT CATHETERIZATION RATES AFTER TREATMENT WITH ONABOTULINUMTOXINA IN PATIENTS WITH OVERACTIVE BLADDER

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Non-neurogenic Voiding Dysfunction I1 Apr 2016MP74-08 REAL-WORLD CLEAN INTERMITTENT CATHETERIZATION RATES AFTER TREATMENT WITH ONABOTULINUMTOXINA IN PATIENTS WITH OVERACTIVE BLADDER Michael Kennelly, Lonny Green, Nancy Fathali, Salim Wehbe, John Joseph Smith, Scott MacDiarmid, Jeffrey Mangel, Marc Schwartz, Tamer Aboushwareb, and Brian Murray Michael KennellyMichael Kennelly More articles by this author , Lonny GreenLonny Green More articles by this author , Nancy FathaliNancy Fathali More articles by this author , Salim WehbeSalim Wehbe More articles by this author , John Joseph SmithJohn Joseph Smith More articles by this author , Scott MacDiarmidScott MacDiarmid More articles by this author , Jeffrey MangelJeffrey Mangel More articles by this author , Marc SchwartzMarc Schwartz More articles by this author , Tamer AboushwarebTamer Aboushwareb More articles by this author , and Brian MurrayBrian Murray More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1705AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Previous randomized controlled trials (RCTs) have reported a 5.0-6.5% incidence of clean intermittent catheterization (CIC) following treatment with onabotulinumtoxinA (onabotA) in patients with overactive bladder (OAB) who were inadequately managed by ≥1 anticholinergic. Retrospective studies with onabotA have reported a higher incidence of CIC. Our goal was to evaluate CIC rates in OAB patients undergoing onabotA treatment in real-world clinical practice with evidence-based exclusion criteria from the RCTs. In a multicenter retrospective chart review, we assessed the rate of voiding dysfunction requiring CIC and the effect of injection technique on the need for CIC. METHODS Patients received onabotA 100U (approved dose) or 200U treatments, administered by experienced injectors, for OAB symptoms between January 2013 and June 2015. As in the onabotA RCTs, patients using CIC or an indwelling catheter for ≥24 hours for voiding dysfunction prior to onabotA injections were excluded. The primary outcome was post-treatment CIC use (lasting >24 hours; based on individual physician's discretion). CIC rates were analyzed by 1st (n=143), 2nd (n=63), and 3rd (n=25) onabotA treatments. Potential baseline predictors of CIC initiation (history of pelvic prolapse, cystocele, diabetes, post-void residual [PVR] urine volume and age) were assessed using a multivariable logistic regression analysis. RESULTS This interim analysis comprised 143 patients; mean age was 66.7 years. CIC was initiated in 2.1% (3/143) of the patients in treatment cycle 1; these CIC patients received the 100U dose. The de novo CIC rate was 2.4% (2/85 patients) in treatment cycles 2 and 3 combined; 3 patients were censored from analysis due to CIC initiation in previous treatment cycles. Overall, 7 CIC events occurred in 5 patients across all treatments (2 patients used CIC in 2 treatment cycles); 4 events had PVR urine volume of 200 to <350 mL, and 3 had PVR >350 mL. None of the baseline characteristics were found to be significant predictors of CIC initiation. CONCLUSIONS In this real-world study of OAB patients treated with onabotA, the incidence of CIC was lower than the rates reported in previous studies, including the onabotA RCTs. There were no significant correlations between baseline characteristics and CIC initiation, although statistical significance may not have been reached due to the low incidence of CIC. Analysis of additional patients and the effect of injection technique on CIC use is ongoing and will be presented. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e972 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Michael Kennelly More articles by this author Lonny Green More articles by this author Nancy Fathali More articles by this author Salim Wehbe More articles by this author John Joseph Smith More articles by this author Scott MacDiarmid More articles by this author Jeffrey Mangel More articles by this author Marc Schwartz More articles by this author Tamer Aboushwareb More articles by this author Brian Murray More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...