Optimal Intravesical Lidocaine Volume for Pain Relief During Office Intra-detrusor Onabotulinum Toxin a Injections: a Prospective Randomized Superiority Trial
University of Louisville
Summary
The purpose of our study is to evaluate the efficacy and safety of different volumes of bladder-numbing medication for pain relief at the time of office bladder Botox injections. This is a randomized prospective, double-blind superiority trial comparing 200 ml 2% lidocaine versus 30 ml 2% lidocaine for office Botox injections.
Description
The volume of 2% intravesical lidocaine solution and efficacy for pain relief at the time of office intradetrusor Botox A injection has not been well studied. Studies evaluating intravesical lidocaine show that it is not sufficiently absorbed by human bladders to achieve serum toxicity levels and only provides superficial local anesthetic effect. Experts agree that intravesical local anesthetic can be given in the office, with approximately 30 to 40 mL of 2% lidocaine instilled via catheter into the bladder for about 20 minutes before injection. However, there is little evidence regarding this…
Eligibility
- Age range
- 18+ years
- Sex
- Female
- Healthy volunteers
- No
Inclusion Criteria: * Adult female, \>18 years, English-speaking (surveys utilized are not validated in all languages) * Able to provide informed consent * Indications: Refractory urge urinary incontinence, Refractory urinary urgency and frequency, Neurogenic bladder (without sensory deficit) Exclusion Criteria: * Untreated urinary tract infection at the time of procedure * Contra-indication to Botox * Contraindication to intravesical lidocaine * Inability to provide informed consent * Pregnancy, breast-feeding, intending to become pregnant within 6 months of treatment
Interventions
- DrugLidocaine 2% without vessel constrictor
different volumes of intravesical 2% lidocaine without epinephrine, all patients will be receiving bladder botox but this will not be compared
Location
- University of Louisville Division of Urogynecology and Reconstructive Pelvic SurgeryLouisville, Kentucky