First UK Experience Using LiNA OperaScope® for Botulinum Toxin Treatment under Local Anaesthesia in Women with Overactive Bladder and a Tolerability Comparison with Previous Smear Test Experience.

[BACKGROUND] Overactive bladder (OAB) is a debilitating condition predominantly affecting women. Whilst onabotulinum toxin A (Botox) injections are an effective surgical treatment, they typically require a full surgical team and an operating theatre and carry the risk of anaesthesia. LiNA OperaScope® offers a novel approach, allowing Botox administration in an outpatient setting with the patient in a supine position, eliminating the need for lithotomy, stirrups or surgical assistance. This paper presents the first UK experience with LiNA OperaScope®, assessing its feasibility, comparing patient tolerability with that of previous cervical smear tests and providing a relatable reference for patient counselling.

[METHODS] Fifty women with OAB refractory to previous treatments underwent Botox injections under local anaesthesia using LiNA OperaScope® in an outpatient setting. Patient and surgeon feedback, including pain scores and procedural ease, was collected. The pain experienced during the procedure was compared with that of prior smear tests.

[RESULTS] The average patient age was 64.8 years (range: 34-88). The cohort was divided into an elderly group (≥75 years) and a younger group (<75 years). The overall pain score for the Botox procedure was 2.2/10, with the elderly group reporting a lower pain score (2.0/10) compared with the younger group (2.3/10). Both groups experienced significantly less pain during the Botox procedure than during smear tests ( < 0.001). The average procedure time was less than 3 min. Two patients developed a urinary tract infection, which was successfully treated with oral antibiotics alone (Clavien-Dindo grade II).

[CONCLUSIONS] LiNA OperaScope® is a feasible and viable option for delivering Botox treatment in women with OAB. It is well tolerated, with patients reporting lower pain levels than those during prior smear tests, making it a relatable and effective tool for better counselling of patients on the procedure.