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

Abstract

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.

Efficacy and safety of mirabegron, a β3‐adrenoceptor agonist, in patients with detrusor hyperactivity and impaired contractility

“…Advanced age, large PVR volume, and low voiding efficiency (VE) at baseline are associated with a considerable risk of developing AEs in patients treated with most anti‐OAB medications . Whether mirabegron treatment of DHIC is effective and tolerable remains uncertain.…”

Urodynamic factors associated with the large capacity bladder and incomplete emptying after prolapse repair (2009‐2015)

“…We selected a PVR greater than 200 mL to define incomplete emptying after surgery, which is consistent with the clinical relevance of the 100 to 200 mL threshold for PVR reported in the literature. 11,[14][15][16] While there is not one single PVR threshold which should prompt intervention, our findings offer insight into the effect that prolapse repair has on incomplete bladder emptying for the large capacity bladder after surgery.…”

“…To look at the time association between any diagnosis of urinary tract infection and longest follow‐up PVR greater than 200 mL, we applied the Kaplan‐Meier cumulative incidence methods (event = longest follow‐up PVR > 200 mL), as utilized by other investigators . Using this approach, any diagnosis of urinary tract infection appeared to be nonsignificantly associated with a higher proportion of patients with a PVR greater than 200 mL at most recent follow‐up, as the HR and CI include the null association (HR, 1.81; CI, 0.69‐4.75).…”

Test–retest reliability of the 20-min pad test with infusion of strong-desired volume in the bladder for female urodynamic stress incontinence

“…OAB is frequently treated by pharmacology, such as antimuscarinics and beta-3 agonists 17 . Refractory OAB can be treated by sacral neuromodulation, transvaginal electrical stimulation or intravesical botox injection 18 , 19 . Based on the finding of good test–retest reliability of the 20-min pad test for women with USI with or without DO, the 20-min pad test seems to be a good tool to assess the severity of SUI with or without OAB.…”