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Introduction: Intravesical onabotulinumtoxinA (BTN/A) has been approved by the Food and Drug Administration for the treatment of overactive bladder (OAB) in patients who are refractory to anticholinergic medications. One of the risks of this intervention is urinary retention. The purpose of this study was to determine factors that predict urinary retention after BTN/A injection for OAB patients.
Materials & Methods: This was a retrospective analysis of patients who received a BTN/A injection at our institution from 2005 to 2013. Patients were excluded if they had neurogenic bladder, a chronic foley catheter, suprapubic tube or intermittent catherization schedule. Urinary retention was defined as needing a placement of foley catheter and/or requiring straight catherization. Data was analyzed utilizing general estimating equation (GEE) analyses.
Results: Based on the inclusion and exclusion criteria, 111 BTN/A injections among 73 unique subjects were reviewed. Mean age was 69.90 +/- 13.78 and 21% were men; the overall rate of urinary retention was 19%. Preoperative post void residual (PVR) (OR 1.013, 95% CI 1.001-1.024, P=0.027) and history of stroke (OR 4.63, 95% CI 2.809-7.637, P<0.0001) were significantly associated with postoperative urinary retention. Age was associated with a decrease in urinary retention (OR 0.96, 95% CI 0.934-1.002, P=0.066).
Conclusions: This data suggests that preoperative PVR and stroke history is a predictor of urinary retention following BTN/A injection. This study also found that as age increased there was a slight decrease in the risk of urinary retention. This suggests that BTN/A injections are well tolerated in the elderly population.