E-Posters-Pilot Study: Perceived Versus Actual Pain Associated with Intravesical Injection of Onabotulinumtoxin A

Pilot Study: Perceived Versus Actual Pain Associated with Intravesical Injection of Onabotulinumtoxin A - Eric S. Chang, MD

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The intravesical injection of onabotulinumtoxin A is a commonly used treatment for idiopathic overactive bladder and urgency urinary incontinence. However, there is no standardization in the number of injections administered in one dose. Previous literature does not define the relative pain associated with this procedure. Given that women are more likely to be undertreated for pain or have their pain dismissed, it is suspected that women receiving intravesical injections of onabotulinumtoxin A may experience more pain than anticipated by providers. <br /><br />In this pilot study, the average pain associated with the procedure was correlated with providers' perceived pain. A single-question survey was distributed to Female Pelvic Medicine & Reconstructive Surgery physicians, who rated the perceived pain of the procedure on a 10-point scale. Patients who underwent the procedure were asked to rate their pain on the same scale within 5 minutes of completion. <br /><br />Results showed that providers' mean perceived pain was 2.3, while the mean actual pain reported by patients was 4.7. This indicates that the procedure is more painful than providers perceive it to be. As there is variation in the administration of intravesical onabotulinumtoxin A, this study suggests opportunities for research in optimizing the procedure to decrease the amount of actual pain patients feel. <br /><br />This study supports previous literature that suggests a bias against women in the treatment of pain. It highlights the need to consider and address the actual pain experienced by patients, especially women, in order to improve their healthcare outcomes.

Keywords

intravesical injection

onabotulinumtoxin A

idiopathic overactive bladder

urgency urinary incontinence

injections administered

pain associated

procedure

perceived pain

women

healthcare outcomes