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What is the true catheterization rate after intravesical onabotulinumtoxinA injection?

International Urogynecology Journal Aug 17, 2017

Patel DN, et al. – Here, researchers sought to find out the true rate of urinary retention requiring clean intermittent catheterization (CIC) in clinical practice. The rate of post–procedure urinary retention requiring catheterization was only 1.6% in the series of 187 intravesical injections for overactive bladder (OAB). This low rate can be attributed to less rigorous criteria for CIC initiation than those applied in previous studies. While important to counsel patients on the risk of retention, patients can be reassured that the actual rate of CIC is low.

Methods

  • For this study, they conducted a retrospective review.
  • This study was performed more than a 3–year period of patients who received 100 units of intravesical onabotulinumtoxinA for the treatment of OAB.
  • Patients were seen 2 weeks after the procedure to measure PVR.
  • CIC was initiated in patients with a PVR ≥ 350 ml and in those with subjective voiding difficulty or acute retention.

Results

  • They found a sum of 187 injections was performed on 99 female patients.
  • CIC was required following three injections (1.6%): for acute retention in two patients and subjective voiding difficulty in one patient with a PVR of 353 ml.
  • Following 12 injections, the patient had a PVR of ≥ 350 ml, and following 29 injections, the patient had a PVR of >200 but <350 ml without symptoms.
  • CIC was not initiated in these 41 patients.
  • None of these patients experienced subsequent retention, and all exhibited resolution of their elevated PVR within two months.

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