The Effect of Symptomatic Stress Urinary Incontinence on Catheterization Rates After Intradetrusor OnabotulinumtoxinA Injections.

IF 1.4 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Female Pelvic Medicine and Reconstructive Surgery Pub Date : 2021-11-01 DOI:10.1097/SPV.0000000000001040

Caroline Brandon, Dominique Malacarne Pape, Cheongeun Oh, Fabiana M Kreines, Sameer S Thakker, Nirit Rosenblum, Victor W Nitti, Benjamin M Brucker, Dianne Glass

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引用次数: 0

Abstract

Objectives: To determine whether catheterization rates after intradetrusor onabotulinumtoxinA injection for nonneurogenic overactive bladder and urgency incontinence differ between women with urgency urinary incontinence only and women with urgency-predominant mixed urinary incontinence.

Methods: This was a retrospective cohort study of patients that underwent intradetrusor onabotulinumtoxinA injection of 100 U for nonneurogenic urgency urinary incontinence. The primary outcome was the difference in catheterization rates between women with urgency urinary incontinence alone compared with women with urgency-predominant mixed urinary incontinence. Descriptive statistics and multivariate logistic regression analysis were performed.

Results: Of the 177 women included in the final analysis, 105 had urgency urinary incontinence and 72 had urgency-predominant mixed urinary incontinence. The overall catheterization rate after onabotulinumtoxinA injection was 11.3%, with significantly fewer women with mixed urinary incontinence requiring catheterization when compared with women with urgency urinary incontinence alone (4.2% vs 16.2%; P = 0.03), despite an older population (P = 0.02). Patient-reported improvement (P = 0.37) and decision to continue onabotulinumtoxinA treatments (P = 0.89) were similar between groups. Multivariate logistic regression analysis revealed that women with mixed urinary incontinence had significantly lower odds of requiring catheterization after onabotulinumtoxinA injections than women with urgency urinary incontinence alone (odds ratio, 0.16; 95% confidence interval, 0.04-0.67; P = 0.01).

Conclusions: Findings suggest that the presence of symptomatic stress urinary incontinence is associated with lower rates of catheterization after intradetrusor onabotulinumtoxinA, but does not compromise efficacy of treatment for urgency-predominant mixed urinary incontinence.

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症状性应激性尿失禁对肌内注射肉毒杆菌毒素后置管率的影响。

目的:探讨非神经源性膀胱过动症和急迫性尿失禁的女性患者，单纯急迫性尿失禁和以急迫性为主的混合性尿失禁，肌内注射肉毒杆菌毒素后留置导尿率的差异。方法:这是一项回顾性队列研究，患者接受肌内注射100 U肉毒杆菌毒素治疗非神经源性急迫性尿失禁。主要结局是单独出现急迫性尿失禁的女性与以急迫性为主的混合性尿失禁女性的导尿率的差异。进行描述性统计和多元逻辑回归分析。结果:纳入最终分析的177例女性中，105例为急迫性尿失禁，72例为急迫性混合性尿失禁。注射肉毒杆菌毒素后的总导尿率为11.3%，混合性尿失禁需要导尿的女性明显少于单纯急迫性尿失禁的女性(4.2% vs 16.2%;P = 0.03)，尽管年龄较大(P = 0.02)。患者报告的改善(P = 0.37)和继续肉毒杆菌毒素治疗的决定(P = 0.89)在两组之间相似。多因素logistic回归分析显示，混合性尿失禁妇女在注射肉毒杆菌毒素a后需要导尿的几率明显低于单纯急迫性尿失禁妇女(优势比，0.16;95%置信区间为0.04-0.67;P = 0.01)。结论:研究结果表明，症状性应激性尿失禁与肌内肉毒杆菌毒素a治疗后较低的导尿率相关，但不影响治疗以紧急为主的混合性尿失禁的疗效。

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来源期刊

Female Pelvic Medicine and Reconstructive Surgery OBSTETRICS & GYNECOLOGY-

CiteScore

2.10

自引率

12.50%

发文量

228

期刊介绍： Female Pelvic Medicine & Reconstructive Surgery, official journal of the American Urogynecologic Society, is a peer-reviewed, multidisciplinary journal dedicated to specialists, physicians and allied health professionals concerned with prevention, diagnosis and treatment of female pelvic floor disorders. The journal publishes original clinical research, basic science research, education, scientific advances, case reports, scientific reviews, editorials and letters to the editor.