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Open Access 07-11-2024 | Overactive Bladder | Original Article

Predictive Factors for Clean Intermittent Catheterization after Intravesical OnabotulinumtoxinA Injections in Women with Overactive Bladder: a Danish Retrospective Cohort Study

Authors: Meryam El Issaoui, Sophia Elissaoui, Marlene Elmelund, Niels Klarskov

Published in: International Urogynecology Journal

Abstract

Introduction and Hypothesis

We aimed to evaluate the clean intermittent catheterization (CIC) rate in women undergoing their first OnabotulinumtoxinA (BTX-A) treatment and to investigate factors predictive of initiating CIC.

Methods

This was a retrospective cohort of women, who had their first BTX-A treatment for symptoms of overactive bladder (OAB) syndrome, with a pretreatment urodynamic study (UDS). We reviewed demographic, medical and gynecological history, UDS, pretreatment bladder diaries, objective examinations, BTX-A treatment details, and post-void residual (PVR) reports in the electronic medical record. Botox® Allergan 100 International Units were injected into the detrusor at 10–20 sites. Statistical analyses included univariate and multivariate logistic regression analyses.

Results

We included 397 women. Median age was 68 (Q1–Q3: 54–76) years. CIC rate was 8.6% (n = 34) following the first BTX-A treatment. Urgency urinary incontinence (UUI) reduced the risk of undergoing CIC (OR 0.30, 95% CI 0.09–0.97). A bladder capacity of 500 ml or greater in the bladder diary increased the risk of CIC (OR 2.46, 95% CI 1.06–5.70), whereas reported leakages were associated with a decreased risk of CIC (OR 0.24, 95% CI 0.10–0.57). Multivariate logistic regression analysis showed that anterior colporrhaphy (OR 3.71, 95% CI 1.52–9.06) and 10-ml increments in median maximum cystometric capacity (OR 1.03, 95% CI 1.00–1.06) predicted CIC, whereas UUI was a protective factor for CIC (OR 0.23, 95% CI 0.07–0.79).

Conclusions

A history of anterior colporrhaphy, large bladder capacity, and absence of incontinence episodes in bladder diary or UDS were risk factors for CIC after the first BTX-A treatment.

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Title: Predictive Factors for Clean Intermittent Catheterization after Intravesical OnabotulinumtoxinA Injections in Women with Overactive Bladder: a Danish Retrospective Cohort Study
Authors: Meryam El Issaoui
Sophia Elissaoui
Marlene Elmelund
Niels Klarskov
Publication date: 07-11-2024
Publisher: Springer International Publishing
Keywords: Overactive Bladder
Kolporraphie Front
Urinary Incontinence
Urinary Incontinence
Published in: International Urogynecology Journal
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-024-05960-8

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