Urology Research & Practice
FEMALE UROLOGY - Original Article

Intravesical injection of botulinum toxin A for treatment of overactive bladder in anticoagulated patients: Is it safe?


Department of Urology, Morriston Hospital, Swansea, Wales


School of Mathematics, Statistics and Applied Mathematics, National University of Ireland, Galway, Ireland


Division of Cancer and Genetics, Cardiff University School of Medicine, Cardiff, Wales

Urol Res Pract 2020; 46: 481-487
DOI: 10.5152/tud.2020.20256
Read: 933 Downloads: 420 Published: 09 October 2020

Objective: This study aimed to identify the complication rate, specifically bleeding, in patients who received anticoagulation undergoing intravesical botulinum toxin A injections.


Material and methods: This study included all patients (n=430) undergoing intravesical injection of botulinum toxin A in a single secondary care center between January 2013 and December 2018. We recorded the use of anticoagulants/antiplatelets and complications. Logistic regression was used to investigate the association between anticoagulant/antiplatelet use and the complications arising, while controlling for age and sex.

Results: We identified 430 procedures in 94 men and 336 women (mean age, 60 years). A total of 79 patients received anticoagulants (18%). Aspirin was the most common anticoagulant (52%). Complication rate in anticoagulated patients was 6% (n=5), and it was 2% in those not on anticoagulants/antiplatelets (n=7). Complications were over 3 times more likely in patients who received anticoagulants/antiplatelets (odds ratio=3.233; 95% confidence interval=0.873, 11.38; p=0.067). There was no difference in the complications between patients with idiopathic symptoms and those with neuropathic overactive bladder. No patients required further surgical intervention, and all except 1 were Clavien–Dindo grade I–II with no mortalities.


Conclusion: Anticoagulated patients undergoing intravesical injections have higher complication risks; however, the treatment outcome is unaffected with no significant morbidity/mortality. This is the first study to demonstrate safe outcomes for this subgroup and can assist in decision making and consenting.


Cite this article as: Wells H, Luton O, Simpkin A, Bullock N, KandaSwamy G, Younis A. Intravesical injection of botulinum toxin A for treatment of overactive bladder in anticoagulated patients: Is it safe? Turk J Urol 2020; 46(6): 481-7.

EISSN 2980-1478