Prolonged urinary retention after intravesical botulinum injection for treatment of idiopathic detrusor overactivity

Botulinum toxin (BTX) has emerged as a treatment of refractory overactive bladder (OAB) and, while well tolerated, there exists concern regarding postoperative urinary retention.

A 75-year-old female underwent intravesical BTX-A injection, which was followed by a prolonged episode of urinary retention, highlighting an unusual duration and degree of UR associated with BTX-A injection in the treatment of idiopathic detrusor overactivity (IDO). This case illustrates clinically significant urinary retention with bladder diaries demonstrating persistent postvoid residual (PVR) measurements exceeding voided volume until 9 month follow up.

Notably, this duration and severity of urinary retention remains rare. However, this case underscores the need to appropriately counsel patients regarding the risks associated with intravesical injection of BTX-A.