Guidance
3 Committee considerations
The evidence
3.1 NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 8 sources, which was discussed by the committee. The evidence included 1 randomised controlled trial and 7 case series. It is presented in the summary of key evidence section in the interventional procedures overview. Other relevant literature is in the appendix of the overview.
3.2 The professional experts and the committee considered the key efficacy outcomes to be: symptom relief, improvement in quality of life, a reduction in the need and frequency of self-catheterisation, improved bladder emptying and a reduction in the need for further procedures.
3.3 The professional experts and the committee considered the key safety outcomes to be: pain, bleeding, infection, stress urinary incontinence, bladder outlet obstruction and botulinum toxicity.
3.4 Four commentaries from patients who had experience of this procedure were received as part of public consultation, which were discussed by the committee.
Committee comments
3.5 Idiopathic chronic non-obstructive urinary retention is not included in the therapeutic indications for botulinum toxin type A.
3.6 Women have the procedure more commonly than men.
3.7 The procedure is most likely to be useful in people with sphincter overactivity.
3.8 The randomised controlled trial evidence was from people with a mixed group of indications.
ISBN: 978-1-4731-5251-9