Early Onset of Intradetrusor OnabotulinumtoxinA for Urgency Urinary Incontinence

Importance The onset of symptom improvement following intravesical onabotulinum toxinA for urgency urinary incontinence is not well known. Objective The objective of this study was to evaluate the early efficacy of intradetrusor onabotulinumtoxinA for the treatment of urgency urinary incontinence. Study Design We performed a prospective observational study of women undergoing intradetrusor onabotulinumtoxinA for the treatment of urgency urinary incontinence. Adult women receiving an initial or subsequent injection of 100 units of intradetrusor onabotulinumtoxinA were included. Participants completed 3-day baseline voiding diaries, the Urinary Distress Inventory-6, and Incontinence Impact Questionnaire-7 before the procedure. Voiding diaries, Urinary Distress Inventory-6, and Incontinence Impact Questionnaire-7 were repeated daily for 14 days postprocedure. Statistical analysis of paired data (preprocedure and postprocedure) was performed using the Wilcoxon signed-rank test. Results Thirty-one participants completed baseline and follow-up questionnaires. The median (range) baseline Urinary Distress Inventory-6 was 33 (8–71) and the Incontinence Impact Questionnaire-7 was 38 (0–100). The median baseline daily voids, urgency urinary incontinence episodes, urgency episodes, and nocturia episodes were 13 (8–20), 5 (2–15), 8 (3–17), and 4 (0–6), respectively. For all measures, day 1 outcomes were significantly improved from baseline. Day 1 median Urinary Distress Inventory-6 was 25 (0–67), Incontinence Impact Questionnaire-7 was 24 (0–81), daily voids were 10 (5–20), daily urgency urinary incontinence episodes were 2 (0–15), daily urgency episodes were 3 (0–20), and daily nocturia episodes were 2 (0–4). Significant improvement persisted over the 14-day follow-up. Conclusions Women undergoing intradetrusor onabotulinumtoxinA for urgency urinary incontinence had significant subjective and objective improvement 1 day postprocedure.