Urinary retention in female OAB after intravesical Botox injection: who is really at risk?

Miotła, Paweł; Cartwright, Rufus; Skorupska, Katarzyna; Bogusiewicz, Michał; Markut–Miotła, Ewa; Futyma, Konrad; Rechberger, Tomasz

doi:10.1007/s00192-016-3212-4

Cited by 40 publications

(41 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…59 Clean intermittent catheterization may also become necessary after later injections even if it was not initially required. Other factors that may increase the risk of CIC include older age (>61-76 years) (LE 2, GR B), 43,60 frailty (LE 2, GR B) 43 and higher parity (particularly a higher number of vaginal deliveries; LE 2, GR B). 60 A recent study has shown that BMI and concomitant comorbidities do not significantly influence PVR volumes and the risk of CIC, even though one would expect that these factors could provoke safety issues.…”

Section: Predictive Factors For Cicmentioning

confidence: 99%

“…Other factors that may increase the risk of CIC include older age (>61-76 years) (LE 2, GR B), 43,60 frailty (LE 2, GR B) 43 and higher parity (particularly a higher number of vaginal deliveries; LE 2, GR B). 60 A recent study has shown that BMI and concomitant comorbidities do not significantly influence PVR volumes and the risk of CIC, even though one would expect that these factors could provoke safety issues. 60 Nevertheless, Wang et al showed that patients with diabetes have a significantly increased incidence of PVR volumes greater than 150 mL (60.4%) compared with nondiabetic patients (33.3%; LE 3, GR C).…”

Section: Predictive Factors For Cicmentioning

confidence: 99%

“…60 A recent study has shown that BMI and concomitant comorbidities do not significantly influence PVR volumes and the risk of CIC, even though one would expect that these factors could provoke safety issues. 60 Nevertheless, Wang et al showed that patients with diabetes have a significantly increased incidence of PVR volumes greater than 150 mL (60.4%) compared with nondiabetic patients (33.3%; LE 3, GR C). 61 Although it may sometimes be necessary to introduce CIC, studies have shown that the need to perform CIC do not negatively impact the outcome of onabotulinumtoxinA therapy, and that improvements in patients' symptoms are similar with and without CIC.…”

Section: Predictive Factors For Cicmentioning

confidence: 99%

“…31,57 It has been shown that the risk of new-onset urine retention with a need for CIC usually disappears 2 weeks after the injections. 60…”

Section: Predictive Factors For Cicmentioning

confidence: 99%

See 3 more Smart Citations

How to assess and predict success or failure of intra-detrusor injections with onabotulinumtoxinA

Przydacz¹,

Gołąbek²,

Chłosta³

2019

Adv Clin Exp Med

View full text Add to dashboard Cite

Intra-detrusor injection therapy with onabotulinumtoxinA is generally accepted as a highly effective, minimally invasive and well-tolerated day procedure for patients with refractory overactive bladder (OAB) and neurogenic detrusor overactivity (NDO). The aim of this study was to summarize currently available methods of assessing treatment efficacy and risk factors that may influence the therapeutic effect of this approach. We found that there are discrepancies in the assessment methods. The evaluation of intra-detrusor injections with onabotulinumtoxinA in clinical trials are not always transposable into day-today practice. Moreover, the primary endpoints in clinical trials do not explore the entirety of meaningful patient-centered outcomes. Therefore, in daily clinical practice with patients with overactive bladder syndrome, the therapy should be assessed with objective measures (bladder diaries) and patient-oriented outcomes analyzing the quality of life (questionnaires). In neurogenic individuals, therapeutic efficacy should be additionally evaluated with urodynamic studies. Potential risk factors that may influence the treatment outcomes include urodynamically proven detrusor overactivity, elevated maximum detrusor pressure, greater maximum cystometric capacity, impaired bladder compliance, older age, male gender, a higher baseline bother score, previous anticholinergic treatment, and repeated injections with a subsequent decline in efficacy. The risk of intermittent catheterization following injections seems to depend on the etiology of detrusor overactivity, the injected dose, the injection technique, and the definition of significant post-void residual urine requiring catheterization.

show abstract

Section: Predictive Factors For Cicmentioning

confidence: 99%

Section: Predictive Factors For Cicmentioning

confidence: 99%

Section: Predictive Factors For Cicmentioning

confidence: 99%

“…31,57 It has been shown that the risk of new-onset urine retention with a need for CIC usually disappears 2 weeks after the injections. 60…”

Section: Predictive Factors For Cicmentioning

confidence: 99%

See 2 more Smart Citations

How to assess and predict success or failure of intra-detrusor injections with onabotulinumtoxinA

Przydacz¹,

Gołąbek²,

Chłosta³

2019

Adv Clin Exp Med

View full text Add to dashboard Cite

show abstract

“…An unwillingness or inability to perform CIC does cause some patients to reject the option of bladder onaBoNT‐A. Recently, age, higher parity, and higher number of vaginal deliveries were all reported as factors that predisposed women to start CIC after onaBoNT‐A . Also, preoperative PVR was associated with increased risk of postoperative urinary retention after onaBoNT‐A injection .…”

Section: Introductionmentioning

confidence: 99%

MicroRNAs as potential biomarkers to predict the risk of urinary retention following intradetrusor onabotulinumtoxin‐A injection

Chermansky

Kadow

Kashyap

et al. 2017

Neurourology and Urodynamics

View full text Add to dashboard Cite

Aims: MicroRNAs (miRs) control post-transcriptional gene expression, and this is relevant in understanding better chronic diseases and treatment outcomes. The role of miRs in the pathology and treatment outcomes of overactive bladder (OAB) is unknown. In this study, we assessed the differential expression of miRs in OAB patients responding with either normal or elevated post-void residual volumes (PVRs) ≥200 mL following intradetrusor injection of onabotulinumtoxin-A (onaBoNT-A). Methods: Female OAB patients refractory to OAB drugs were consented for this study. Cystoscopic-guided punch bladder biopsy was obtained at the time of injection of onaBoNT-A 100 units. The expression of 13 miR species, selected for their known effect on neurotrophin expression and smooth muscle function, was measured. PVRs and urine nerve growth factor (NGF) levels were measured at baseline and at the follow-up visit. Results: Fourteen patients with mean age of 66 years were consented. Of these patients, nine maintained PVRs <200 mL after onaBoNT-A injection to comprise the low PVR group. The other five patients with PVRs ≥200 mL comprised the high PVR group. The expression of miR221 and miR125b was upregulated by 11-and 2-fold, respectively, in patients who responded with low PVRs after onaBoNT-A (P < 0.05). Urine NGF levels at baseline were not different between the two groups. Conclusions: This study suggests that deficiency in the pretreatment expression of miR221 and miR125b may predispose OAB patients to high PVRs following intradetrusor onaBoNT-A. Additional studies are needed to better understand the role of miRs in OAB.

show abstract

Predicting outcomes after intradetrusor onabotulinumtoxina for non‐neurogenic urgency incontinence in women

Hendrickson

Xie

Rahn

et al. 2021

Neurourology and Urodynamics

View full text Add to dashboard Cite

Aims: Develop models to predict outcomes after intradetrusor injection of 100 or 200 units of onabotulinumtoxinA in women with non-neurogenic urgency urinary incontinence (UUI).Methods: Models were developed using 307 women from two randomized trials assessing efficacy of onabotulinumtoxinA for non-neurogenic UUI. Cox, linear and logistic regression models were fit using: (1) time to recurrence over 12 months, (2) change from baseline daily UUI episodes (UUIE) at 6 months, and (3) need for self-catheterization over 6 months. Model discrimination of Cox and logistic regression models was calculated using c-index. Mean absolute error determined accuracy of the linear model. Calibration was demonstrated using calibration curves. All models were internally validated using bootstrapping.Results: Median time to recurrence was 6 (interquartile range [IQR]: 2-12) months. Increasing age, 200 units of onabotulinumtoxinA, higher body mass index (BMI) and baseline UUIE were associated with decreased time to recurrence. The c-index was 0.63 (95% confidence interval [CI]: 0.59, 0.67). Median change in daily UUIE from baseline at 6 months was −3.5 (IQR: −5.0, −2.3). Increasing age, lower baseline UUIE, 200 units of onabotulinumtoxinA, higher BMI and IIQ-SF were associated with less improvement in UUIE. The mean absolute error predicting change in UUIE was accurate to 1.6 (95% CI:1.5, 1.7) UUI episodes. The overall rate of self-catheterization was 17.6% (95% CI: 13.6%-22.4%). Lower BMI, 200 units of onabotulinumtoxinA, increased baseline postvoid residual and maximum capacity were associated with higher risk of self-catheterization. The c-index was 0.66 (95% CI: 0.61, 0.76). The three calculators are available at http://riskcalc.duke.edu.

show abstract

Urinary retention in female OAB after intravesical Botox injection: who is really at risk?

Cited by 40 publications

References 24 publications

How to assess and predict success or failure of intra-detrusor injections with onabotulinumtoxinA

How to assess and predict success or failure of intra-detrusor injections with onabotulinumtoxinA

MicroRNAs as potential biomarkers to predict the risk of urinary retention following intradetrusor onabotulinumtoxin‐A injection

Predicting outcomes after intradetrusor onabotulinumtoxina for non‐neurogenic urgency incontinence in women

Contact Info

Product

Resources

About