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’.

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

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.

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.

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.