Urinary tract infections in the intradetrusor onabotulinumtoxinA population

Abstract

The aim of our study was to determine the incidence of Urinary Tract Infections (UTI) following intradetrusor onabotulinumtoxinA injections within our trust. This was a retrospective study of all patients who underwent intradetrusor onabotulinumtoxinA injections at our trust from August 2005 to 2015. Information was taken from our botulinum database, clinic letters and microbiology results. The primary outcome criterion was a positive urine culture together with symptoms suggestive of infection within 6 months post-procedure. A total of 290 intradetrusor onabotulinumtoxinA procedures were performed on 86 patients. The rate of UTI within 6 months following a procedure was 33%. There was a high resistance rate to our standard antibiotic prophylaxis, which was changed together with the addition of pre-procedure urine cultures and an on the day urine dipstick test. A re-audit was performed between January and June 2016 of 41 procedures and showed a reduction in UTI incidence to 20%. The rate of UTI post procedure within our trust was 33%. Following the implementation of multiple management protocol changes, a re-audit showed a reduction of UTI incidence to 20%.