How are patients prepped for botulinum toxin injections to treat neurogenic detrusor overactivity?

Updated: Mar 06, 2019
  • Author: Pamela I Ellsworth, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Intradetrusor injection of onabotulinumtoxinA may be performed via flexible or rigid cystoscopy and may involve either local anesthesia (with or without sedation) or general anesthesia, depending on the patient’s sensory status, anxiety level, and risk of autonomic dysreflexia. In patients who are at risk for autonomic dysreflexia or have experienced autonomic dysreflexia with previous bladder filling, consideration of monitoring or pretreatment may be indicated.

Patients undergoing injection of botulinum toxin A should not have an acute urinary tract infection. It is recommended that prophylactic antibiotics (except aminoglycosides, because of the potential for drug interactions) be administered 1-3 days before treatment, on the day of treatment, and 1-3 days after treatment.


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