Further, because urinary sensation may be altered after Botox, women may not experience bothersome symptoms of retention. Nevertheless, more data on possible short- and long-term consequences are needed before changing clinical management of this type of retention (ie, I recommend continuing to treat retention rather than watchful waiting).
Until more data are available on risks versus benefits, I recommend against using Botox in women at high risk for complications associated with partial urinary retention. I would be particularly concerned about elderly women at risk of urinary tract infection that may lead to urosepsis.