SUFU 2020: Can Urodynamic Parameters Predict the Need to Catheterize after Intravesical Injections of Onabotulinum Toxin A for Overactive Bladder

Scottsdale, Arizona (UroToday.com) This was a retrospective review to assess assessed whether pre-operative UDS findings can predict the need to catheterize (intermittently or indwelling) after Botox A injections.

There were 418 patients (median age 61 years, range 22-90,128 men) having intravesical Botox A injections for refractory OAB symptoms between 2006 and 2018 was conducted. The outcome of Botox A was categorized by 5-point PGII when last seen or when contacted by telephone if the last review was greater than 6 months previously. The need to self-catheterize (ISC) or have an indwelling urethral (IDC) or suprapubic (SPC) catheter was noted and correlated with the urodynamic parameters.

What they found that 49% of patients had had previous significant pelvic surgery. Urodynamic traces were available for review on 309 (74%) patients; 214 women median age 59 years (range 22-90) and 95 men median age 69 years (range 27-94) having Botox A during this time period under the care of 4 consultant surgeons. New-onset catheterization was required by 77 (36%) of women and 32 (34%) of men post-Botox A. Statistical analysis was by Students T-Test and Chi-Square Test.

The outcomes are listed in Table 1:

pelvic_surgery.png

The authors concluded that intravesical Botox A was significantly more successful in women (71%) than men (61%). ISC or catheterization was required by 35% and was significantly more likely in women with DO wet (p=0.007). Other urodynamic parameters were not predictive of the need for ISC.


Presented by: Mehwash Nadeem, Clinical fellow in Female, Functional, Restorative Urology and Neuro-Urology, University College London Hospitals NHS Foundation Trust
Co-Authors: Kristina Aleksejeva, Gemma Scrimgeour, Richard Axell, Habiba Yasmin, Raveen Saigal, Stephen Unterberg, Mahreen Pakzad, Rizwan Hamid, Jeremy Ockrim, Tamsin Greenwell
FFR Urology, University College London Hospital

Written by: Bilal Farhan, MD, Assistant Professor, Division of Urology, University of Texas, Medical Branch, Texas; @BilalfarhanMD, at the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction Winter Meeting, SUFU 2020, February 25 - February 29, 2020, Scottsdale, Arizona
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