Predictive factors of adverse events after intravesical suburothelial onabotulinumtoxina injections for overactive bladder syndrome—A real‐life practice of 290 cases in a single center

Jiang, Yuan‐Hong; Ong, Hueih-Ling; Kuo, Hann‐Chorng

doi:10.1002/nau.22892

Cited by 25 publications

(43 citation statements)

References 32 publications

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“…Although age, baseline Qmax, PVR and bladder contractility index were statistically significant in our univariate analysis (Table 1), these variables failed to remain significant in multivariate analysis (Table 1). The finding of low voiding efficiency as a predictor is similar to the data reported by Jiang et al 10. and Hsiao et al 15…”

Section: Discussionsupporting

confidence: 91%

“…However, variables such as age, comorbidities (including diabetes mellitus), baseline Qmax, PVR, Pdet.Qmax or bladder contractility index were not predictive factors. Previous studies have shown that age, comorbidities, baseline Qmax, PVR, Pdet.Qmax and bladder contractility index are associated with large PVR after intravesical onabotulinum toxin type A injection1011121314. Comorbidities such as diabetes mellitus and Pdet.Qmax were not statistically significant in our univariate analysis (Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies reported that the following characteristics were associated with large PVR after treatment: male patients, >61 years old, baseline Qmax ≤15 mL/sec, PVR ≥ 100 mL, voiding efficiency <90%, comorbidities, and diabetes10111213. However, only comorbidities were identified by multivariate logistic regression analysis13, the other studies did not perform multivariate analysis101112.…”

Section: Discussionmentioning

confidence: 99%

“…However, only comorbidities were identified by multivariate logistic regression analysis13, the other studies did not perform multivariate analysis101112. Thus, our predictors for post-treatment large PVR should be more valuable and reliable.…”

Section: Discussionmentioning

confidence: 99%

“…Large PVR is also observed in patients with a baseline maximum flow rate (Qmax) ≤15 ml/sec, PVR ≥ 100 ml, and voiding efficiency <90% after the intravesical injection of onabotulinum toxin type A10. Additionally, Liao et al .…”

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confidence: 94%

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Urodynamic prognostic factors for large post-void residual urine volume after intravesical injection of onabotulinumtoxinA for overactive bladder

Hsiao

Lin

Kuo

2017

Sci Rep

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The aim of this study was to identify factors predicting large post-void residual (PVR) (defined as ≥200 mL), an important unsolved problem, after an intravesical injection of onabotulinumtoxinA in patients with overactive bladder syndrome. The data showed that 133 of 290 patients had a large PVR after treatment. Multivariate analysis found that the baseline 3-day daytime frequency episodes and voiding efficiency were independent predictors for postoperative large PVR. A receiver operating characteristic (ROC) curve analysis showed the following optimum cut-off values: (1) 3-day daytime frequency episodes = 25, which has a ROC area of 0.72; and (2) voiding efficiency = 89%, which has a ROC area being 0.66. The predicted logit transformation of probability of large PVR, logit(p), for a given 3-day daytime frequency episodes (a) and voiding efficiency (b%) can be denoted by logit(p) = −5.18 + 0.07 × a + 0.04 × b, with a cutoff value of logit(p) = 0.34 and a ROC area of 0.79. The median value of the persistent large PVR interval was 5 months. In conclusion, low 3-day daytime frequency episodes (<25) and low voiding efficiency (<89%) are associated with large PVR. Besides, logit(p) <0.34 can be used to predict large PVR for its higher ROC area.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 94%

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Urodynamic prognostic factors for large post-void residual urine volume after intravesical injection of onabotulinumtoxinA for overactive bladder

Hsiao

Lin

Kuo

2017

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Efficacy and safety of onabotulinumtoxinA injection in patients with refractory overactive bladder: First multicentric study in Turkish population

Önem

Bayrak

Demirtaş

et al. 2017

Neurourology and Urodynamics

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Aims: To investigate the efficacy and safety of intradetrusor onabotulinumtoxinA (onaBoNT-A) injection in patients with overactive bladder (OAB) refractory to antimuscarinic treatment.Methods: A total of 80 patients with OAB symptoms were enrolled in this prospective multicenter study and received 100 U intradetrusor onaBoNT-A injection.The changes from baseline in the frequency of voiding, urge urinary incontinence (UI) and urge episodes, mean and maximum bladder capacities, uroflowmetry, post-void residual urine volume (PVR), quality of life score, and treatment benefit scale score were assessed. The need for a second injection,and treatment-related adverse events were also examined postoperatively.Results: OnaBoNT-A injection significantly decreased the UI episodes (P = 0.0001), the mean voiding frequency (P = 0.0001), and the urgency episodes (P = 0.0001) in the third month compared to baseline. Similarly, the mean bladder capacity, and maximal bladder capacity were increased (P < 0,05). The quality of life scores improved by 57.1% compared to the pretreatment rate (P = 0,0001). No significant change was observed in the PVR or maximum flow rate. Urinary retention developed in 3 (3.75%) patients and urinary infection and transient hematuria were observed in five patients (6.25%) each. The UI episodes, voiding frequency and urgency episodes were significantly lower at the 9th month than at baseline (all P = 0.0001).Overall 67% of the patients continued to experience benefits from the injection. Sixteen patients (20%) required a second injection in the third month. Eight patients were lost to follow-up at the last visit in the 9th month, and 34 of the remaining 56 patients required a second injection at the 9th month. Cumulatively, 50 (63%) patients needed re-injections. Conclusions:Our results demonstrated that the onaBoNT-A injection produced significant improvement in all OAB symptoms with a low incidence of treatment related adverse events.

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What is the exact working mechanism of botulinum toxin A and sacral nerve stimulation in the treatment of overactive bladder/detrusor overactivity? ICI‐RS 2017

Malde

Fry

Schurch

et al. 2018

Neurourology and Urodynamics

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Predictive factors of adverse events after intravesical suburothelial onabotulinumtoxina injections for overactive bladder syndrome—A real‐life practice of 290 cases in a single center

Abstract: AUR, UTI, and large PVR volume are common AEs after BoNT-A treatment. Patients with overactive bladders that are at risk of developing AEs after BoNT-A injection should be informed of the possible AEs. Neurourol. Urodynam. 36:142-147, 2017. © 2015 Wiley Periodicals, Inc.

Cited by 25 publications

References 32 publications

Urodynamic prognostic factors for large post-void residual urine volume after intravesical injection of onabotulinumtoxinA for overactive bladder

Urodynamic prognostic factors for large post-void residual urine volume after intravesical injection of onabotulinumtoxinA for overactive bladder

Efficacy and safety of onabotulinumtoxinA injection in patients with refractory overactive bladder: First multicentric study in Turkish population

What is the exact working mechanism of botulinum toxin A and sacral nerve stimulation in the treatment of overactive bladder/detrusor overactivity? ICI‐RS 2017

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