Real-World Retention Rates After Intravesical OnabotulinumtoxinA for Idiopathic Overactive Bladder

Area of Science:

• Urology
• Pharmacology

Background:

• Intravesical onabotulinumtoxinA (BoNT-A) is used for idiopathic overactive bladder.
• Incomplete bladder evacuation requiring catheterization is a known risk of BoNT-A, but reported rates vary and are generally low in clinical trials.

Purpose of the Study:

• To evaluate the rate of symptomatic acute urinary retention requiring catheterization after initial intravesical BoNT-A in a private practice setting for patients with idiopathic overactive bladder.

Main Methods:

• Retrospective study of 103 patients with idiopathic overactive bladder receiving their first intravesical BoNT-A from 2010 to 2014.
• Data collected included demographics, baseline postvoid residual (PVR), urodynamic findings, and BoNT-A dose.
• Urinary retention defined as symptomatic and requiring catheterization for PVR ≥ 200 mL.

Main Results:

• 20.3% (21/103) of patients developed symptomatic retention requiring catheterization.
• No significant differences in baseline characteristics or injected BoNT-A dose were found between groups.
• The retention group had a higher incidence of bacteriuria and symptomatic urinary tract infections.

Conclusions:

• The rate of catheterization due to urinary retention after initial intravesical BoNT-A appears higher in a private practice setting compared to clinical trials.
• This finding is crucial for accurately counseling patients on the potential risks and benefits of BoNT-A therapy.