Real Life Outcomes Following Intravesical Injection of Onabotulinum Toxin A for Idiopathic Overactive Bladder and Neurogenic Detrusor Overactivity

Scrimgeour G1, Toia B1, Kocadag H1, Pakzad M1, Hamid R1, Ockrim J1, Greenwell T1

Research Type

Clinical

Abstract Category

Overactive Bladder

Abstract 739
Non Discussion Abstract
Scientific Non Discussion Abstract Session 37
Overactive Bladder Detrusor Overactivity Quality of Life (QoL)
1.University College London Hospital Trust
Links

Abstract

Hypothesis / aims of study
Intravesical onabotulinum toxin A (Onabotox A) injections have been shown to improve or significantly improve refractory symptomatic idiopathic overactive bladder (OAB) and neurogenic detrusor overactivity (NDO) in between 61.8% and 67.7% with post injection intermittent self catheterisation (ISC) rates of 6.5-43% in recent prospective clinical trials. We have evaluated real life outcomes to assess whether they live up to the ‘ideal’.
Study design, materials and methods
141/183 consecutive patients attending for their 1st injection of Onabotox A under our care between 2006 and 2015 had full data available on retrospective notes review. Data analysed were patient demographics, aetiology, dose of Onabotox A, 5 point Likert Patient Global Impression of Improvement score (PGII) where 5 is much improved and 3 is no change, need to ISC, choice for repeat Onabotox A injection(s) and number of repeat injections.
Statistical analysis of parametric data was by Student’s T Test and of non parametric data was by Mann Whitney U Test. Significance was assigned at  < 0.05
Results
56 (38%) patients were male. Mean patient age was 58 years  (range 21-93 years). Total number of Onabotox A injection procedures in these patients was 481. Outcomes from their Onabotox A treatment(s) are detailed in Table 1.
Interpretation of results
73% OAB and 78% of NDO patients are improved or very much improved after Onabotox A injections, 92-100% of whom elect for repeat treatments. ISC is required in 45-70% of patients.
Concluding message
Real world outcomes are equivalent or better to trials in terms of symptom improvement but worse in terms of need to ISC. Patients should be proleptically taught ISC prior to initiating Onabotox A treatment.
Figure 1 Table 1
Disclosures
Funding none Clinical Trial No Subjects Human Ethics not Req'd retrospective case review Helsinki Yes Informed Consent Yes