Prolonged urinary retention after intravesical botulinum injection for treatment of idiopathic detrusor overactivity.

INTRODUCTION: Botulinum toxin (BTX) has emerged as a treatment of refractory overactive bladder (OAB) and, while well tolerated, there exists concern regarding postoperative urinary retention.

CASE: A 75-year-old female underwent intravesical BTX-A injection, which was followed by a prolonged episode of urinary retention, highlighting an unusual duration and degree of UR associated with BTX-A injection in the treatment of idiopathic detrusor overactivity (IDO). This case illustrates clinically significant urinary retention with bladder diaries demonstrating persistent postvoid residual (PVR) measurements exceeding voided volume until 9 month follow up.

CONCLUSIONS: Notably, this duration and severity of urinary retention remains rare. However, this case underscores the need to appropriately counsel patients regarding the risks associated with intravesical injection of BTX-A.