Saftey And Efficacy Of Onabotulinumtoxina Injections In Octo And Nonagenarians

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Non-neurogenic Voiding Dysfunction II1 Apr 2018MP79-08 SAFTEY AND EFFICACY OF ONABOTULINUMTOXINA INJECTIONS IN OCTO AND NONAGENARIANS Patricia M. Zahner MD, Laura L. Giusto MD, Jessica C. Lloyd MD, Juan M. Guzman-Negron MD, Shree Agrawal BS, Courtenay K. Moore MD, Raymond R. Rackley MD, Sandip P. Vasavada MD, and Howard B. Goldman MD Patricia M. Zahner MDPatricia M. Zahner MD More articles by this author , Laura L. Giusto MDLaura L. Giusto MD More articles by this author , Jessica C. Lloyd MDJessica C. Lloyd MD More articles by this author , Juan M. Guzman-Negron MDJuan M. Guzman-Negron MD More articles by this author , Shree Agrawal BSShree Agrawal BS More articles by this author , Courtenay K. Moore MDCourtenay K. Moore MD More articles by this author , Raymond R. Rackley MDRaymond R. Rackley MD More articles by this author , Sandip P. Vasavada MDSandip P. Vasavada MD More articles by this author , and Howard B. Goldman MDHoward B. Goldman MD More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2676AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES OnabotulinumtoxinA (BTX-A) injections are commonly used third-line therapies for treatment of overactive bladder (OAB). The most common side effects, urinary retention and urinary tract infections (UTIs), may deter some providers from performing this treatment in the elderly, even though rate of OAB increases with age with associated increased morbidity and decreased quality of life. We examine the rate of complications and efficacy in patients 80 years or greater versus patients between the ages of 50-70 years receiving intradetrusor BTX-A for the treatment of OAB. METHODS A retrospective case series of patients who underwent BTX-A injection at a tertiary care center from January 2007 through September 2017 was conducted. Patients were stratified into an "elderly" cohort, greater than 80 years old (EC), and a comparator "younger" cohort (YC) 50-70 years. Demographics, clinical characteristics, post-BTX-A complications and patient-reported satisfaction following treatment were collected. Statistical analyses included chi-square and t-tests for patient characteristics and univariable and multivariable logistic regression models for outcomes. RESULTS The EC consisted of 62 patients (48%) with a mean age of 84 years, ranging from 80-94 years, versus the YC of 68 patients (52%) with a mean age of 59 years, ranging from 50-70 years. Among EC patients, 76% had comorbid conditions (47% moderate to severe), and in the YC, 65% had comorbidities (31% moderate to severe) (p = 0.24). Complication rates between both groups were 23% for the EC and 16% for the YC (p = 0.36). Among the EC, 11% experienced urinary retention versus 4% in the YC (p = 0.14). UTI was seen in 6% of the EC and 7% of the YC (p = 0.84). The most common complication for the elderly cohort was retention (54%) and UTI (56%) for the younger cohort. With respect to efficacy, 47% of the EC reported satisfaction after their final treatment, versus 53% of the YC (p = 0.31). Regardless of age group, patients with severe comorbid conditions compared to those with none were associated with a higher likelihood of re-hospitalization (OR:16.1, p = 0.03). CONCLUSIONS The number of patients aged 80 years or more seeking care in urology offices for OAB continues to grow. Our data suggest that intradetrusor BTX-A injections are safe and effective in the elderly population, with no significant difference in UTIs or urinary retention versus younger patients. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1083 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Patricia M. Zahner MD More articles by this author Laura L. Giusto MD More articles by this author Jessica C. Lloyd MD More articles by this author Juan M. Guzman-Negron MD More articles by this author Shree Agrawal BS More articles by this author Courtenay K. Moore MD More articles by this author Raymond R. Rackley MD More articles by this author Sandip P. Vasavada MD More articles by this author Howard B. Goldman MD More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...