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Variation in Defining Retention After Onabotulinum Toxin A for Overactive Bladder: A Systematic Review.

Peris R Castaneda1, Andrew Chen1, Paige Kuhlmann2

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Urinary retention definitions vary widely in studies of onabotulinum toxin A (BTX) for overactive bladder (OAB). This inconsistency hinders accurate risk assessment and comparison of BTX treatment outcomes.

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Area of Science:

  • Urology
  • Pharmacology
  • Clinical Research

Background:

  • Urinary retention is a significant adverse event following intravesical onabotulinum toxin A (BTX) injections for overactive bladder (OAB).
  • Reported rates of urinary retention vary substantially, from 1.6% to over 40%, suggesting potential inconsistencies in how retention is defined and reported.

Approach:

  • A systematic review was conducted using MEDLINE and EMBASE databases.
  • Studies published between January 2000 and December 2020 involving adult OAB patients treated with BTX and reporting urinary retention were included.

Key Points:

  • Fifty-three studies met the inclusion criteria, revealing six distinct definitions for urinary retention.
  • Clean intermittent catheterization (CIC) initiation was the most common metric (60.4%), but definitions varied.
  • Postvoid residual (PVR) volume thresholds for CIC initiation ranged from 100 to 400 mL, with inconsistent reporting for asymptomatic and symptomatic patients.

Conclusions:

  • The definition of urinary retention following intravesical BTX for OAB is not standardized across studies.
  • This lack of standardization impedes accurate evaluation of retention risk and hinders the comparison of treatment outcomes between different research.