San Diego, CA USA (UroToday.com) Injection of onabotulinumtoxinA (BTX-A), a procedure for patients with overactive bladder (OAB) and can be performed with either rigid or flexible cystoscopies. Flexible cystoscopy has the benefit of providing more comfort, especially for male patients.
In order to perform an accurate and thorough BTX-A injection with a flexible cystoscope, having an injection needle with adequate irrigant flow and maximal scope deflection is necessary.
Researchers from the Mayo Clinic evaluated the angles of deflection and irrigant flow rates of three commercially available intradetrusor injection needles used for flexible cystoscopic injection of BTX-A to determine if any needle provided a technical advantage.
Three intradetrusor injection needles: NBI070 (Coloplast, Minneapolis, MN), DIS200 (Laborie, Williston, VT), NM-101C-0427/MAJ-565/MAJ-655 (Olympus, Center Valley, PA) were used with an empty working channel and with the working channels of two modern flexible cystoscopes: Karl Storz 11272CU1 (KS) and Olympus CYF-V2 (O). With the empty working channel, KS had a total range of deflection of 341 degrees and an average flow rate of 5.7 mL/s, while O had a total range of deflection of 281 degrees and an average flow rate of 5.5 mL/s. The total range of deflection with the KS cystoscope was reduced to 275 degrees, 250 degrees, and 311 degrees, while that with the O cystoscope was reduced to 195 degrees, 157 degrees, and 257 degrees, for Coloplast NBI070, LAborie DIS200, and Olympus NM-101C-0427, respectively. The average flow rate with the KS cystoscope was reduced to 1.0 mL/s, 0.1 mL/s, and 0.7 mL/s, and that with the O cystoscope was reduced to 0.5 mL/s, 0.1 mL/s, and 0.4 mL/s, in Coloplast NBI070, LAborie DIS200, and Olympus NM-101C-0427, respectively.
The authors confirm that the needles vary in total deflection angle and maximum flow rate. They conclude that among commercially available intradetrusor BTX-A injection needles, Olympus NM-101C-0427 gives the greatest total range of deflection and has the greatest elasticity and flexibility while Coloplast NBI070 allows for the best flow rate.
Presented By: Robert Williams*, Jesse Dove, Steven Petrou, David Thiel
Written By: Susan Li, Department of Urology, University of California, Irvine at the 2016 AUA Annual Meeting - May 6 - 10, 2016 – San Diego, California, USA