Abstract
Introduction and hypothesisIntravesical onabotulinumtoxinA (Botox) injections are effective for the treatment of idiopathic overactive bladder (OAB) symptoms. The aim of our study was to assess the predisposing factors for urinary retention in women with OAB after intravesical Botox injection.MethodsAll participants were women of European descent with idiopathic OAB. OnabotulinumtoxinA (100 U) was administered in 20 intra-detrusor injections. Analysis was performed based on the results of safety assessments made during follow-up (FU) visits on weeks 2, 4 and 12, in 208 women who were treated with Botox injections for refractory OAB and who completed all FU visits.ResultsWomen who required clean intermittent self-catheterisation (CISC) and those with post-void residual (PVR) greater than 200 ml were older in comparison with patients with PVR between 50 and 200 ml. Patients who required CISC were also characterised by higher parity and particularly by a higher number of vaginal deliveries. Other factors such as body mass index or comorbidities did not significantly influence PVR and the risk of CISC.ConclusionsElderly and/or multiparous women are at increased risk of urinary retention after intravesical 100-U Botox injections. The risk of new onset urine retention in our study has completely disappeared 2 weeks after Botox injections. Based on our results of the way in which the PVRs have changed over time, we can conclude that OAB patients should be optimally assessed during the first 2 weeks after Botox injections.
Highlights
Introduction and hypothesis IntravesicalonabotulinumtoxinA (Botox) injections are effective for the treatment of idiopathic overactive bladder (OAB) symptoms
An abstract with preliminary results of this study was accepted for oral poster presentation (OP 12) at the 2016 International Urogynecological Association (IUGA) Meeting in Cape Town, South Africa
Elderly and/or multiparous women are at increased risk of urinary retention after intravesical 100-U Botox injections
Summary
OnabotulinumtoxinA (Botox) injections are effective for the treatment of idiopathic overactive bladder (OAB) symptoms. The aim of our study was to assess the predisposing factors for urinary retention in women with OAB after intravesical Botox injection. Following behavioural therapy anticholinergic agents and/or mirabegron are the mainstay of pharmacological treatment of OAB. In non-responders who are inadequately managed with such oral therapies there is a need for the intravesical injections of onabotulinumtoxinA (Botox) [4]. The National Institute for Health and Care Excellence (NICE) guidelines highlight that before invasive treatments, which include intravesical botulinum toxin injections, women with refractory OAB should undergo a multidisciplinary team review to ensure that all
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