To compare the safety and durability of a single intravesical trigonal-only versus 20 trigone-sparing injections of OnabotulinumtoxinA (BTA) for refractory OAB.
A chart review of all idiopathic OAB patients treated with BTA from January 2016 to December 2018 was performed.
Outcomes measures included: inter-injection interval, post-void residual (PVR), urinary tract infections (UTI), urinary retention requiring catheterization, and procedure time (min). Statistical analyses were performed using independent sample t-tests.
Baseline characteristics were comparable for the two groups, data on 69 treatments (19 patients trigone-only) were compared to 105 treatments (26 patients trigone-sparing). There were no differences in the inter-injection intervals or rates of UTI. The trigone-only group exhibited a lower mean PVR (113 ml vs 160 ml, p < 0.02), lower proportion with PVR > 150 ml (23% vs. 39%, p < 0.03), lower rate of urinary retention (5.3% vs. 17.4%, p < 0.02), and shorter procedure time (4.3 min vs. 5.7 min, p < 0.01). There were no cases of vesico-ureteral reflux.
While interpretation remains speculative, the results of this observational study suggest that a single trigone-only injection appears to be as safe and durable as multiple trigone-sparing injections but maybe quicker to perform and appears to have a lower impact on voiding function. Larger series and adequately powered prospective randomized clinical trials are warranted to validate the findings of this pilot study.
International urology and nephrology. 2021 Mar 19 [Epub ahead of print]
Jessica Ton, Perrin Downing, Eboo Versi, Stefanie van Uem, Sonya Ephraim, Miles Murphy, Vincent Lucente
Anne Arundel Medical Center, Annapolis, MD, USA., Abington Hospital-Jefferson Health, Abington, PA, USA., Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA. ., Department of Urology, Stanford University School of Medicine, San Francisco, USA., Mercyhealth System, Rockford, IL, USA., Institute for Female Pelvic Medicine, Allentown, PA, USA.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/33742316