Expert Opinions on Best Practices for Overactive Bladder Management with onabotulinumtoxinA

Area of Science:

• Urology
• Pharmacology

Background:

• OnabotulinumtoxinA is an FDA-approved treatment for overactive bladder (OAB) refractory to oral therapies.
• Procedural variations in onabotulinumtoxinA intradetrusor injections impact patient experience.

Framework:

• A panel of experts convened to establish best office practices for intravesical onabotulinumtoxinA administration.
• Guidelines emphasize clear patient counseling on OAB therapies, including onabotulinumtoxinA, per AUA and SUFU guidelines.

Implementation:

• Office-based procedures are preferred over hospital settings.
• Staff involvement is crucial for optimizing patient experience, compliance, and retreatment.
• Recommended anesthetic is viscous lidocaine instillation 15 minutes prior to injection.
• Slower injection speed and fewer sites (1-20) in the lower bladder improve distribution and comfort.

Implications:

• Optimizing the patient journey from initial consultation to post-treatment follow-up is key for long-term compliance.
• Standardized best practices can improve patient outcomes and satisfaction with onabotulinumtoxinA therapy for OAB.