title: Urinary retention in female OAB after intravesical Botox injection: who is really at risk?
abstract: OBJECTIVE
  Intravesical onabotulinumtoxinA (Botox) injections are effective for the treatment of idiopathic overactive bladder (OAB) symptoms. The aim of our study was to assess the predisposing factors for urinary retention in women with OAB after intravesical Botox injection.
  
  
  METHODS
  All participants were women of European descent with idiopathic OAB. OnabotulinumtoxinA (100 U) was administered in 20 intra-detrusor injections. Analysis was performed based on the results of safety assessments made during follow-up (FU) visits on weeks 2, 4 and 12, in 208 women who were treated with Botox injections for refractory OAB and who completed all FU visits.
  
  
  RESULTS
  Women who required clean intermittent self-catheterisation (CISC) and those with post-void residual (PVR) greater than 200 ml were older in comparison with patients with PVR between 50 and 200 ml. Patients who required CISC were also characterised by higher parity and particularly by a higher number of vaginal deliveries. Other factors such as body mass index or comorbidities did not significantly influence PVR and the risk of CISC.
  
  
  CONCLUSIONS
  Elderly and/or multiparous women are at increased risk of urinary retention after intravesical 100-U Botox injections. The risk of new onset urine retention in our study has completely disappeared 2 weeks after Botox injections. Based on our results of the way in which the PVRs have changed over time, we can conclude that OAB patients should be optimally assessed during the first 2 weeks after Botox injections.
authors.affiliation: 2nd Department of Gynaecology, Medical University of Lublin, ul. Jaczewskiego 8, 20-954, Lublin, Poland. pmiotla@wp.pl.
authors.forename: Pawel
authors.initials: P
authors.lastname: Miotla
authors.affiliation: Department of Epidemiology and Biostatistics, Department of Urogynaecology, Imperial College London, London, UK.
authors.forename: Rufus
authors.initials: R
authors.lastname: Cartwright
authors.affiliation: 2nd Department of Gynaecology, Medical University of Lublin, ul. Jaczewskiego 8, 20-954, Lublin, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Skorupska
authors.affiliation: 2nd Department of Gynaecology, Medical University of Lublin, ul. Jaczewskiego 8, 20-954, Lublin, Poland.
authors.forename: Michal
authors.initials: M
authors.lastname: Bogusiewicz
authors.affiliation: Department of Paediatric Pulmonology and Rheumatology, Medical University of Lublin, Lublin, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Markut-Miotla
authors.affiliation: 2nd Department of Gynaecology, Medical University of Lublin, ul. Jaczewskiego 8, 20-954, Lublin, Poland.
authors.forename: Konrad
authors.initials: K
authors.lastname: Futyma
authors.affiliation: 2nd Department of Gynaecology, Medical University of Lublin, ul. Jaczewskiego 8, 20-954, Lublin, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Rechberger
mesh_terms: D065087:Acetylcholine Release Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D000283:Administration, Intravesical; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000187:drug effects; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*; D016055:Urinary Retention / Q000209:etiology*
chemical_list: D065087:Acetylcholine Release Inhibitors; D019274:Botulinum Toxins, Type A
keywords: Botox; Botulinum toxin A; Overactive bladder; Residual urine volume; Urgency incontinence; Urine retention