SCOTTSDALE, AZ USA (UroToday.com) - This study examined factors at the time of injection that impact pain and the duration of the procedure.
Data was obtained from a longitudinal registry of 604 patients who received onabotulinumtoxin A (BTA) for a variety of lower urinary tract symptoms. 
Pain was assessed using a self-reported visual analogue pain scale ranging from 0 (no pain) to 10 (worst pain imaginable). There were no differences in reported pain scores in naïve versus experienced patients and the procedure was well tolerated. However, there were differences in pain scores and procedure time between surgeons. 88% performed BTA injections using local anesthetics, 74% utilized a rigid cystoscope/Cook Williams needle, and 21% a flexible scope and Olympus needle.
The authors found that a combination of a rigid scope and Cook Williams needle does not significantly increase patients reported pain, results in a significantly shorter procedure time, and may be a more efficient injection of BTA. Comparative studies into different scope/needle combinations and injection techniques is warranted in future studies. An important finding of this study was that surgeon technique impacts both pain experienced by the patient and procedure time.
Funding: Unrestricted research grant from Allergan Canada Inc.
Presented by K Carlson, R. Baverstock, A.Civitarese, and T. Crump at the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU) Winter Meeting - February 24 - 28, 2015 - JW Marriott Camelback Inn Resort & Spa - Scottsdale, AZ USA
Department of Surgery, University of Calgary, Alberta Bladder Centre, Canada
Reported by Diane K. Newman, DNP, FAAN, BCB-PMD, medical writer for UroToday.com