Document Detail

Safety and tolerability of sedation-free flexible cystoscopy for intradetrusor botulinum toxin-A injection.
MedLine Citation:
PMID:  17296397     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Intradetrusor botulinum toxin-A injection is a promising emerging therapy for neurogenic and idiopathic overactive bladder that is refractory to current antimuscarinic agents. We evaluated a sedation-free procedure using flexible endoscopy to perform intradetrusor botulinum toxin-A injection using a validated pain score to assess the tolerability of this technique. MATERIALS AND METHODS: Five men and 22 women with idiopathic overactive bladder refractory to antimuscarinics were prospectively evaluated and randomized to 100 U (14) or 150 U botulinum toxin-A (13). Subjects underwent BTA injection with intravesical lidocaine using a 14Fr Olympus flexible cystoscope, which accommodates a 27 gauge flexible Olympus injection needle. Patients were evaluated with the visual analog scale to evaluate discomfort during and 15 minutes after the procedure. Procedure time was recorded. RESULTS: In 22 female patients the mean pain score was 3.1 (range 0 to 10) during the procedure and 0.7 (range 0 to 7) 15 minutes after the procedure. In 5 male patients the mean pain score was 1.6 (range 0 to 3.5) during the procedure and 0.0 with all reporting no pain 15 minutes after the procedure. Mean procedure time was 4.5 minutes (range 4 to 6). Only 1 of the 27 patients requested sedation before any subsequent injections. CONCLUSIONS: Sedation-free intradetrusor botulinum toxin-A injection using intravesical lidocaine and flexible endoscopy is a well tolerated and safe procedure to perform in an office setting.
Brian L Cohen; Rolando Rivera; Paholo Barboglio; Angelo Gousse
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Journal of urology     Volume:  177     ISSN:  0022-5347     ISO Abbreviation:  J. Urol.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-02-13     Completed Date:  2007-04-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1006-10; discussion 1010     Citation Subset:  AIM; IM    
Department of Urology, Miller School of Medicine, University of Miami, Miami, Florida 33136, USA.
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MeSH Terms
Administration, Intravesical
Anesthetics, Local / administration & dosage
Botulinum Toxin Type A / administration & dosage*
Cystoscopy / adverse effects*,  methods*
Injections, Intramuscular / adverse effects*,  methods*
Lidocaine / administration & dosage
Middle Aged
Neuromuscular Agents / administration & dosage*
Pain / etiology
Pain Measurement
Prospective Studies
Urinary Bladder, Overactive / drug therapy
Reg. No./Substance:
0/Anesthetics, Local; 0/Botulinum Toxin Type A; 0/Neuromuscular Agents; 137-58-6/Lidocaine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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