Oral vs Intravesical Analgesia for Office Bladder Botox Injections

Inclusion Criteria:

• Non-pregnant, adult females 18 years of age or older

• Diagnosis of idiopathic overactive bladder

• Planning office-based bladder injection of onabotulinumtoxinA

• Willing and able to complete all study related items and interviews

• Grossly neurologically normal on exam

Exclusion Criteria:

• Known neurologic diseases (multiple sclerosis, Parkinson Disease, CVA within 6 months,myasthenia gravis, Charcot-Marie-Tooth disease, peripheral neuropathy, and completespinal cord injury) believed to affect urinary function

• Planned injection of >100 units of onabotulinumtoxinA

• OnabotulinumtoxinA given for another indication within the previous 3 months (ifcumulative dose would total >400 units)

• Any intradetrusor onabotulinumtoxinA injections in the previous 12 months

• Serum creatinine level greater than twice the upper limit of normal within the yearprior to enrollment

• Allergy to lidocaine

• Allergy to onabotulinumtoxinA

• Allergy to phenazopyridine

• Untreated urinary tract infection (UTI)

• Currently pregnant or lactating.

• Known urinary retention (post-void residual >200mL) and inability to performintermittent self-catheterization

• Uninvestigated hematuria (gross or microscopic)

• Current or prior bladder malignancy

• Previous bladder augmentation or surgically altered detrusor muscle

• Prior pelvic radiation

• Primary language other than English or Spanish