
%0 Journal Article
%A Kealey, Josh 
%A H. Yao, Henry 
%A Cheng, Janice 
%A E. O'Connell, Helen 
%A Gani, Johan 
%T Busting for Botox&#xae;: an analysis of rebooking methods and delay to reinjection of intravesical Botulinum toxin A
%J Australian and New Zealand Continence Journal
%D 2022/06/01
%V 28
%N 3
%P 23-28
%K 
%R https://doi.org/10.1071/CJ22009
%U https://www.publish.csiro.au/paper/CJ22009 
%X The objective of this study was to determine if the method of rebooking intravesical Botulinum neurotoxin A injections for treatment of detrusor overactivity causes treatment delays. The records of patients diagnosed with urodynamically proven detrusor overactivity treated with Botox&#xae; between March 2005 and October 2018 were included in a retrospective multicentre case series. Rebooking method was categorised into: (i) patient-initiated rebooking methods, (ii) doctor-initiated rebooking methods and (iii) automatic rebooking. Primary outcome was the proportion of patients with delay in reinjection >1 month after cessation of effect. A total of 336 patients were included in this study and results showed that 180/336 underwent a second and 122/180 a third cycle of Botulinum neurotoxin A. Patient- reported efficacy ranged from 73&#x2013;84%, urinary tract infection rate was 8&#x2013;11% per cycle and de novo urinary retention rate was 8.2&#x2013;16.1% per cycle. The method of rebooking was patient-initiated in 45% (n=68) of cases and doctor-initiated in 55% (n=83) for the second injection. The rate of delay to retreatment was not clinically significant between the two groups at 33% and 37%, respectively. For those who progressed to a third cycle, the method of rebooking was automated in 11% (n=12) of patients and doctor- or patient-initiated rebooking in 89% (n=97). Automatic rebooking method resulted in a significantly lower rate of delay to injection (8% vs 44%, p=0.026). Significant delays occur in the reinjection of intravesical Botulinum neurotoxin A for detrusor overactivity. These delays can be reduced by utilising an automatic rebooking method once dose and duration of effect are established. 
