MP17-16 CHARACTERIZATION OF TONIC ACTIVITY OF EXTERNAL URETHRAL SPHINCTER DURING VOIDING UNDERLYING INEFFICIENT VOIDING AFTER SPINAL CORD INJURY IN RATS

been widely recommended since bacteriuria might impair efficacy and cause urinary tract infection (UTI), but the evidence is very limited. Thus, the aim of the present study was to evaluate if an antibiotic prophylaxis is needed in patients with bacteriuria undergoing intradetrusor onabotulinumtoxinA injections. METHODS: Between 06/2012 and 12/2014, a consecutive series of 154 patients undergoing a total of 273 treatments with intradetrusor onabotulinumtoxinA injections for refractory NDO were prospectively evaluated. Before treatment, urine samples were collected by sterile catheterisation for urinalysis and culture. Patients with no clinical signs for UTI underwent intradetrusor onabotulinumtoxinA injections and no antibiotic prophylaxis was given. Efficacy and safety of intradetrusor onabutulinumtoxinA injections were assessed and compared between patients with and without bacteriuria prior treatment. RESULTS: Bacteriuria was found in 73% (200/273) prior intradetrusor onabotulinumtoxinA injections. Following treatment, UTI occurred in 7% (5/73) of cases with sterile urine culture and in 5% (9/ 200) with bacteriuria. 2 patients were hospitalised because of febrile UTI, both showed no bacteriuria before treatment. One patient with pretreatment bacteriuria suffered from prolonged, but self-limiting gross haematuria. Intradetrusor onabotulinumtoxinA injections were clinically and urodynamically successful in 70% (192/273). The treatment effect lasted for a mean of 10 months and was similar (p1⁄40.56) in patients with (12 15 months) and without (10 12 months) bacteriuria. In addition, no association between bacteriuria and treatment-related adverse events (odds ratio 0.64, 95% confidence interval (CI) 0.231.81, p1⁄40.4), nor for therapy failure (odds ratio 0.78, 95% CI 0.43-1.43, p1⁄40.4) was detected. CONCLUSIONS: Bacteriuria in patients undergoing intradetrusor onabotulinumtoxinA injections for refractory NDO did not affect efficacy and safety outcomes. Thus, antibiotic prophylaxis seems not to be justified and needs to be critically reconsidered, especially taking into account the alarming antibiotic resistance worldwide.