E-Posters-Evaluating and Mapping Pain in Intravesical Onabotulinumtoxin A Treatments for Overactive Bladder

Evaluating and Mapping Pain in Intravesical Onabotulinumtoxin A Treatments for Overactive Bladder - Louise R Wannamaker, MD

Back to course

Pdf Summary

This study explores the feasibility and tolerability of in-office intravesical onabotulinumtoxin A (BTA) administration under local anesthesia for the treatment of overactive bladder (OAB). OAB is characterized by urinary urgency, frequency, and nocturia, often accompanied by urge urinary incontinence. It affects around 33 million Americans and can decrease quality of life and increase anxiety and depression.<br /><br />Traditionally, OAB has been treated with behavioral modifications and medication, which may have side effects that are poorly tolerated by older patients. In 2013, the FDA approved BTA as a second line therapy for OAB. BTA is thought to inhibit release of acetylcholine and reduce detrusor activity, leading to improved symptoms.<br /><br />This study enrolled 48 women aged 24-88 with OAB who underwent intravesical BTA injections in an outpatient setting. The pain experienced during the BTA injections was compared to pain experienced during catheterization and cystoscopy. Pain scores were obtained using visual analog and Wong Baker FACES scales.<br /><br />The results showed that there was no significant difference in pain between intravesical BTA injections and cystoscopy. While there was a slight increase in pain throughout the procedure, there was no significant difference in pain scores between the first 10 injections and the last 10 injections. Additionally, 95.8% of patients reported they would undergo the procedure again.<br /><br />Overall, this study demonstrates that in-office intravesical BTA injections under local anesthesia are feasible and well tolerated for the treatment of OAB. The study adds to existing research by showing that pain during the procedure is similar to other commonly performed in-office procedures, and that there is no significant difference in pain among different injection sites. These findings highlight the potential benefits of reducing operative time and costs related to anesthesia in the treatment of OAB.

Keywords

intravesical onabotulinumtoxin A

local anesthesia

overactive bladder

OAB treatment

urinary urgency

urge urinary incontinence

pain during injections

catheterization

feasibility

tolerability