Is there a PVR cutoff over which you worry about urinary retention when giving bladder botox to spontaneously voiding patients with suprapontine lesions?

I am not worried about numbers, but symptoms. If the patient is improved and happy, then I am not concerned about PVR unless infections become an issue.

I usually stick to the Botox package insert which says that it is contraindicated for intradetrusor use in patients with PVR>200 mL who are not routinely performing CIC. I strongly suggest that any patient learns CIC before Botox who has some impaired emptying.