Predictive factors of adverse events after intravesical suburothelial onabotulinumtoxina injections for overactive bladder syndrome—A real‐life practice of 290 cases in a single center

Aims Patients often experience adverse events (AEs) after intravesical onabotulinumtoxinA (BoNT‐A) treatment for overactive bladder refractory to antimuscarinic agents. We investigated the prevalence and predictive factors of AEs in such patients. Methods A total of 290 patients underwent intravesical BoNT‐A (100 U) suburothelial injection. The age, gender, overactive bladder subtypes, medical co‐morbidities, and neurological diseases of the patients were recorded. The maximum flow rate (Qmax), voided volume, post‐void residual (PVR) volume, and voiding efficiency (VE) at baseline were analyzed to identify adverse events within 3 months after treatment. Results Acute urinary retention (AUR) developed in 24 patients (8.3%), and urinary tract infection (UTI) occurred in 44 (15.2%) within 3 months of treatment. Large PVR volume (>200 ml) occurred in 81 (27.9%), 68 (24.3%), and 49 (18.4%) patients 1, 3, and 6 months after treatment, respectively. AUR developed significantly more often in men, patients >61 years old, those with a baseline Qmax ≤15 ml/sec, PVR ≥100 ml, and VE <90%. Patients older than 61 years had a higher incidence of large PVR 1 month after treatment. Female gender and a baseline PVR volume ≥100 ml had a greater incidence of UTI. Age >61 years, low Qmax, low voiding efficiency, and large PVR at baseline were also risk factors for adverse events. Conclusion AUR, UTI, and large PVR volume are common AEs after BoNT‐A treatment. Patients with overactive bladders that are at risk of developing AEs after BoNT‐A injection should be informed of the possible AEs. Neurourol. Urodynam. 36:142–147, 2017.