Patients have poor compliance with repeat OnabotulinumtoxinA injections for overactive bladder

Nguyen A1, Tam J2, Du C1, Wang Q1, Hung M2, Kim J2

Research Type


Abstract Category

Overactive Bladder

Abstract 652
Overactive Bladder 2
Scientific Podium Short Oral Session 33
Friday 31st August 2018
15:42 - 15:50
Hall C
Overactive Bladder Detrusor Overactivity Urgency/Frequency Voiding Dysfunction Retrospective Study
1. Stony Brook University School of Medicine, 2. Stony Brook University Medical Center Department of Urology

Anh Nguyen



Hypothesis / aims of study
Intra-detrusor onabotulinumtoxin A (Botox®) injection is an efficacious treatment for overactive bladder (OAB). There is a lack of literature characterizing compliance with Botox therapy. We report the outcomes of Botox injection treatment at our institution and evaluate factors which correlate with continuation of maintenance injections.
Study design, materials and methods
A retrospective chart review was performed on all patients who received Botox injections from April 2013 to October 2017. Patients who received one injection of Botox were compared to those who received more than one. All data analysis was performed with SPSSv24.
We identified 175 patients who received at least one Botox injection. After the first injection, 86% (150/175) reported subjective symptom improvement. Of those who reported improvement, 54% (81/150) followed up for a second injection. Of those who reported no improvement 24% (6/25) also received a second injection. In total, 50% (87/175) returned for a second injection. Patients who received multiple injections were more likely to have perceived symptomatic improvement (p=0.034), and neurological disorders (p=0.011); those who received multiple injections were less likely to have side effects (p=0.027) (Figure 1). There was no significant difference in age, gender, BMI, or distance to clinic between these groups. Even among patients who reported improvement after Botox injection, compliance for subsequent injections was low (Figure 2).
Interpretation of results
Our data suggest that the presence of neurological disorders may influence the continuation of Botox therapy. Additionally, we found that despite reported symptomatic improvement, a significant proportion of patients did not follow up for repeat injection. This may be related to the presence of side effects which were less common in patients who chose to continue therapy.
Concluding message
There is a paucity of literature regarding the factors associated with maintenance of Botox injections to treat OAB. Our data shows that despite symptomatic improvement reported by 86% of patients in our study, there is a lack of continuation with onabotulinumtoxin injections. Further investigation is required to delineate the factors leading to discontinuation of Botox therapy for treatment of OAB.
Figure 1
Figure 2
  1. Lindsey Cox and Anne P Cameron. OnabotulinumtoxinA for the treatment of overactive bladder.
Funding None Clinical Trial No Subjects Human Ethics Committee Stony Brook University IRB Helsinki Yes Informed Consent Yes