PD44-09 A BLADDER INJECTION SYSTEM AND A SPECIFIC INJECTION PROTOCOL REDUCE URINARY RETENTION FOLLOWING ONABOTULINUMTOXINA TREATMENT OF OVERACTIVE BLADDER (OAB)

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You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Non-neurogenic Voiding Dysfunction III (PD44)1 Apr 2020PD44-09 A BLADDER INJECTION SYSTEM AND A SPECIFIC INJECTION PROTOCOL REDUCE URINARY RETENTION FOLLOWING ONABOTULINUMTOXINA TREATMENT OF OVERACTIVE BLADDER (OAB) John Smith, Jeffrey Proctor*, Scott MacDiarmid, Bradley Jacobs, Eric Gywnn, and Lonny Green John SmithJohn Smith More articles by this author , Jeffrey Proctor*Jeffrey Proctor* More articles by this author , Scott MacDiarmidScott MacDiarmid More articles by this author , Bradley JacobsBradley Jacobs More articles by this author , Eric GywnnEric Gywnn More articles by this author , and Lonny GreenLonny Green More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000931.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Injecting onabotulinumtoxinA into the bladder wall effectively treats OAB but many patients find the risk of post procedure urinary retention unacceptable. Two recent studies report reduced incidence of urinary retention with a protocol that avoids the bladder dome and injects the lateral edges of the bladder. The objective of this post market, prospective study was to assess the safety and efficacy of a bladder injection system using this protocol. METHODS: Female patients being treated for OAB participated in the study. A cystoscope lens inserted into a single use introducer with a rotatable shape memory cannula and needle (Fig. 1), was placed into the bladder. The cannula/needle was then advanced to the wall and the drug injected into tissue in 10 - 40 sites, per the protocol. see jpgFig. 1 Bladder Injection System Patients ranked their pain, 0 (no pain) to 10 (worst pain ever), during the procedure and were contacted 5-21 days post treatment, to document outcome and the necessity of clean intermittent catheterization. Tolerance of the procedure was based on mean pain levels; safety, on procedure-related adverse events. RESULTS: 143 procedures were completed successfully. 120 patients received 100 units of Botox; 23, 200 units. 95 had 10 injections; 4, 12 injections; 37, 20 injections; and 7, 40 injections. There were no adverse events Two patients noted pain with the first injection but no pain with subsequent injections when the injection angle was adjusted tangentially. 90% of patients reported symptom relief. 1 (0.7%) patient required clean intermittent catheterization. CONCLUSIONS: This bladder injection system with its rotatable shape memory cannula/needle and a compound curved distal end enabled injecting the lateral edges of the bladder with little to no manipulation of the cystoscope/introducer. This may account for patients reporting little to no discomfort during the procedure. These results replicate those of two other studies reporting significantly reduced urinary retention associated with this protocol. A rationale for the protocol is proposed. Source of Funding: Uro 1 Medical © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e910-e910 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information John Smith More articles by this author Jeffrey Proctor* More articles by this author Scott MacDiarmid More articles by this author Bradley Jacobs More articles by this author Eric Gywnn More articles by this author Lonny Green More articles by this author Expand All Advertisement PDF downloadLoading ...

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