Very Low, Real-Time Rate of Urinary Retention after Intradetrusor Botox® for Non-Neurogenic Overactive Bladder - Open Journal of Obstetrics and Gynecology

OJOG > Vol.7 No.8, August 2017

Very Low, Real-Time Rate of Urinary Retention after Intradetrusor Botox^® for Non-Neurogenic Overactive Bladder ()

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DOI: 10.4236/ojog.2017.78092 1,156 Downloads 2,720 Views

Author(s)

Kirin K. Syed¹, Christopher S. Gomez², Angelo E. Gousse^1*

Affiliation(s)

¹Bladder Health and Reconstructive Urology Institute, Miramar, FL, USA.
²Female Urology, Neurourology, Voiding Dysfunction and Reconstruction, Department of Urology, University of Miami, Miami, FL, USA.

ABSTRACT

Introduction: According to the most recent AUA/SUFU guidelines, intradetrusor onabotulinumtoxinA (BTN/A) is a standard, evidence strength grade B, third line treatment option for refractory non-neurogenic overactive bladder (OAB). Urinary retention is the most common clinically significant reported side effect ranging from 5.4% to 43% in previous studies. The aim of this study was to investigate the real-time rate of urinary retention in patients treated with BTN/A for refractory non-neurogenic OAB in a multi-institutional study. Methods: Retrospective chart review identified 71 patients who were treated with 100U BTN/A for refractory non-neurogenic OAB from August 2011 to July 2015 at two institutions. Using a flexible cystoscope, 100U Botox&reg reconstituted with 10 ml normal saline was administered. Injections of 1 ml (10 units/ mL) were administered in 10 evenly distributed sites sparing the trigone. Pre and post BTN/A post-void residuals (PVR) were reviewed. Urinary retention was defined as PVR > 200 mL requiring clean intermittent catheterization (CIC). Results: After exclusion, the study group consisted of 66 patients with a mean age of 67 years and 30% were men. Mean pre and post-procedural PVR were 14.06 mL and 69.21 mL. Eight patients (12.12%) were noted to have elevated PVR > 200 mL post injection however only one patient (female) required initiation of CIC. The rate of urinary retention was 1.5% (N = 1). There was no correlation with age, history of previous radiation, diabetes or prior use of a neuromodulator device. Conclusions: To the best of our knowledge, this is the first study to demonstrate a very low risk of real-time urinary retention rates in appropriately selected patients treated with BTN/A for refractory non-neurogenic OAB outside of a clinical trial setting.

KEYWORDS

Intradetrusor OnabotulinumtoxinA, Refractory Non-Neurogenic Overactive Bladder, Urinary Retention, OAB, Urinary Retention Rate, Botox^®

Share and Cite:

Syed, K. , Gomez, C. and Gousse, A. (2017) Very Low, Real-Time Rate of Urinary Retention after Intradetrusor Botox^® for Non-Neurogenic Overactive Bladder. Open Journal of Obstetrics and Gynecology, 7, 915-921. doi: 10.4236/ojog.2017.78092.

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