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of patients for systemic therapy and has been shown to be
prognostic in patients presenting initially with mRCC. We
aimed to determine if the IMDC-M predicts outcome following CN.
Methods: Clinical data from 250 patients presenting with
mRCC between 2001-2017 were collected retrospectively. IMDC-M stratification was calculated for each
patient, when sufficient data was available. Comparisons
and survival analysis was performed using SPSS.
Results: Sufficient data was currently available for 215
patients (86 (40%) IMDC-M intermediate risk [IR] and
129 (60%) IMDC-M poor risk [PR]). CN was performed in
110 (51.1%) patients and was performed more commonly
in IR patients than PR patients (65% and 42%, p<0.001).
While there was a greater overall survival (OS) in patients
undergoing CN with IR compared to PR (p<0.001), there
was significantly improved median OS in those patients
undergoing CN compared to those without CN in both
IR (28 months and 12 months, p<0.001) and PR (14
months and 3 months, p<0.001) patients. IMDC-M, and
CN were both predictive of OS on multivariate cox
regression analysis.
Conclusion: We have validated the prognostic utility of
the IMDC-M in patients presenting with mRCC, which
may prove useful for counseling patients. However, this
prognostic tool should not be used alone for predicting
outcome after CN, as CN may have an OS benefit in all
risk groups. Further work investigating additional predictive parameters of outcome from CN is ongoing.
2017. Patients were evaluated with pre-operative videourodynamic study and urethral pressure profilometry.
Results: 10 female patients with mean age 45.5 years (1880years) were identified. 4 had urodynamic evidence of
bladder outflow obstruction (2 had detrusor sphincter dyssynergia), and 6 had an acontractile detrusor.The mean preop mid-urethral closure pressure (MUCP) was 93.3cmH20
(mean expected MUCP was 45). 6 had failed previous Sacral
Nerve Stimulation. 4 women were voiding pre-onabotulinumtoxinA, 4 were performing clean intermittent self-catheterisation (CISC), and 2 had an indwelling suprapubic
catheter (SPC). After onabotulinumtoxinA, 6 were voiding,
2 were performing CISC, and 2 remained with an SPC.
Median pre-op QMax improved from 8.5ml/s to 12.5ml/s,
and mean post void residual volume decreased from 244mls
to 94mls. 4 patients reported quality of life improvement
after treatment, however 1 reported short lived benefit
lasting less than 3 months. 2 patients went onto repeat
treatments. There were no significant adverse events. 1
patient developed transient stress urinary incontinence.
Conclusion: OnabotulinumtoxinA to the EUS, is a valid
treatment in females with voiding dysfunction, where therapeutic options are limited. The results can be short lived
and patients must be made aware. Further study is
required, with longer term follow up.
ePoster Session 10:
Female, Neurological and
Urodynamic Urology 2
Wednesday 27 June
11:00 - 12:30
Room 12
Chairs: Shahzad Shah & Neil Harris
Luton O1, Smith H1, Lindly A1, Kneen A1, Younis A1
1Morriston Hospital, Swansea, United Kingdom
P10-1 OnabotulinumtoxinA injection to the
external urethral sphincter for voiding dysfunction
in females: a tertiary centre experience
Trimboli M1, Seth J1, O'Connor E1, Itam S1, Hamid R1,
Ockrim J1, Greenwell T1, Pakzad M1
1University College London Hospital, United Kingdom
Aims: Treatment options for voiding dysfunction in
females are limited. The aim of this study was to examine
the functional outcomes of onabotulinumtoxinA injections into the external urethral sphincter (EUS) for voiding dysfunction in females.
Methods: A retrospective analysis of a prospective database was performed. Cases were performed from 2015 to
P10-2 Intravesical botulinum toxin-A injection
for the treatment of overactive bladder in
anticoagulated patients - Is it safe?
Introduction: Intravesical Botulinum Toxin A (BoNT-A)
injections are an effective treatment of overactive bladder
refractory to medical therapies.
Currently there is a lack of evidence surrounding the risk
of haemorrhage to anticoagulated patients receiving this
treatment. This patient group was either excluded from
clinical trials prior to publication of data or their anticoagulation was reversed prior to treatment.
The aim of this single centre study was to identify the rate
of haematuria as significant adverse events (SAE) to this
patient group.
Methods: Retrospective analysis of 353 procedures of
intravesical BoNT-A using patient records over a 4 year
period in a single centre.
SAE were defined as visible haematuria requiring admission.
Results: 353 procedures; Male (n = 75) Female (n = 278),
mean age 60.7 years. 68 procedures recorded with patients
receiving anticoagulant(AC)/Antiplatelets (AP) therapy
(19.3%). Warfarin was the most commonly encountered
anticoagulant (57.9%).
Of the patients taking AC/AP therapy SAE rate = 5.9% (n=
4) in comparison to 0% on those who were not on AC/AP.
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