From the Division of FPMRS, TriHealth, Cincinnati, OH.
Female Pelvic Med Reconstr Surg. 2021 Apr 1;27(4):225-229. doi: 10.1097/SPV.0000000000001001.
This study aimed to determine if routine assessment of patients after onabotulinumtoxinA injections for overactive bladder is necessary to detect clinically significant voiding dysfunction.
This retrospective cross-sectional cohort study analyzed patients who underwent intravesical injection of onabotulinumtoxinA for overactive bladder during a 4-year period. Patients were included for analysis if they returned for an office follow-up visit within 1 month of administration. Baseline demographic data; procedural details; postvoid residual volumes; abnormal postprocedure voiding symptoms, including urinary frequency, pain, or inability to void; urinary tract infections; and initiation of intermittent self-catheterization were recorded. Descriptive statistics, point-biserial and Pearson correlation analyses were performed.
Two hundred thirty-seven injections were included in our analysis. Fifteen encounters, from 13 patients, required the initiation of intermittent self-catheterization (6.3%). The median postvoid residual in those treated with intermittent self-catheterization was 300 mL (min, max: 200, 750 mL); all had received 100 units of onabotulinumtoxinA. The most common symptom among those requiring intermittent self-catheterization was urgency (n = 13; 87%), whereas 93% (n = 14) had at least 1 bothersome symptom. Correlation analyses showed a weak positive correlation with elevated postvoid residual volume and a history of prolapse repair (r = 0.269, P = 0.004), and prior pelvic surgery (r = 0.205, P = 0.029).
Clinically relevant urinary retention that required intermittent self-catheterization after onabotulinumtoxinA injection for overactive bladder occurred in 6.3% of participants in this sample. The vast majority of patients who required intermittent self-catheterization described symptoms that they were able to self-identify.
本研究旨在确定在接受过肉毒毒素 A 注射治疗过度活跃膀胱的患者中进行常规评估是否有必要检测到临床显著的排尿功能障碍。
本回顾性横断面队列研究分析了 4 年内接受过膀胱内注射肉毒毒素 A 治疗过度活跃膀胱的患者。如果患者在注射后 1 个月内返回门诊随访，则纳入分析。记录基线人口统计学数据；手术细节；剩余尿量；异常术后排尿症状，包括尿频、疼痛或无法排尿；尿路感染；以及间歇性自我导尿的开始。进行描述性统计、点二项式和 Pearson 相关分析。
我们的分析包括 237 次注射。13 名患者中有 15 次需要间歇性自我导尿（6.3%）。接受间歇性自我导尿治疗的患者的中位残余尿量为 300ml（最小，最大：200,750ml）；所有患者均接受了 100 单位的肉毒毒素 A。需要间歇性自我导尿的患者最常见的症状是尿急（n=13；87%），而 93%（n=14）至少有 1 个症状困扰。相关分析显示，残余尿量升高与脱垂修复史（r=0.269，P=0.004）和先前的盆腔手术（r=0.205，P=0.029）有弱正相关。
在本样本中，接受过肉毒毒素 A 注射治疗过度活跃膀胱的患者中，有 6.3%的患者出现了需要间歇性自我导尿的临床相关尿潴留。需要间歇性自我导尿的患者中，绝大多数患者描述了他们能够自我识别的症状。
