The Use of cineMRI to Evaluate Botox in Patients With Medication Refractory Overactive Bladder

Overactive bladder (OAB) is defined by the International Continence Society as urinary
frequency and urgency, with or without urge urinary incontinence. The burden of OAB on the
American public is immense in both human and financial terms. Despite this burden, there is a
lack of effective diagnostic and treatment modalities for OAB. Other than two-dimensional
video urodynamics, which has remained relatively unchanged for decades, there is a lack of
diagnostic modalities that will allow investigators to characterize subtypes of OAB and
measure the effects of treatment on bladder physiology. Newer imaging techniques are
desperately needed to help guide treatment and predict and improve outcomes of different
treatment modalities. Intravesical botulinum toxin is a minimally invasive treatment for OAB
refractory to medical therapy. Despite the widespread use of intravesical botulinum toxin
injection for OAB refractory to medical therapy, to date the optimal placement of the drug
has not been determined. Typically ten injections are given, either dispersed evenly across
the bladder or in two rows of five injections. However, it remains unknown which injection
method will optimize outcomes and reduce the risk of urinary retention after Botox®. This
lack of knowledge is a direct result of the fact that there has been no mechanism to study
the effect of Botox® on bladder filling and emptying in a three-dimensional fashion.
CineMRI-UDS will provide this mechanism, and has the potential to significantly improve care
and urologic education by enhancing the understanding of bladder physiology.

Inclusion Criteria:

- Female

- Age 21 years or older

- Overactive bladder symptoms

Exclusion Criteria:

- Age less than 21 years

- Inability to give informed consent

- Claustrophobic