Botulinum toxin for the treatment of lower urinary tract symptoms: A review

Sahai, Amit; Khan, Mohammad Shamim; Fowler, Clare J.; Dasgupta, Prokar

doi:10.1002/nau.20090

Cited by 54 publications

(25 citation statements)

References 86 publications

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“…Other side effects of BTX-A injections are rare, such as allergic reaction to the toxin or transient flu. A few cases of generalized muscle weakness after bladder injections have been reported (17) and not observed in our series.…”

Section: Discussionmentioning

confidence: 49%

“…Later examinations were not reported, as this study focuses on the response to the treatment. Urodynamic investigations were done complying with ICS recommendations (17).…”

Section: Discussionmentioning

confidence: 99%

“…The induced hypocontractility of the detrusor by the treatment led to urinary retention that often required intermittent self-catheterization (17).…”

Section: Discussionmentioning

confidence: 99%

“…BTX-A bladder injection reduces the incidence of symptomatic urinary tract infections (16). The effect lasts between six and 12 months in smooth muscle, such as the bladder (6,17). In the literature, the populations studied are mostly composed of patients suffering from SCI (57%) and fewer patients suffering from MS (17%) (14).…”

Section: Introductionmentioning

confidence: 99%

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Botulinum toxin A for the treatment of neurogenic detrusor overactivity in multiple sclerosis patients

et al. 2011

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Purpose: Neurogenic detrusor overactivity (NDO) is common in patients who suffer from multiple sclerosis (MS). When the usual pharmacological treatment fails, botulinum toxin type A (BTX-A) injections can be proposed. The safety and efficacy of this treatment are already well known, but only a few studies focus on its use in patients with MS. Materials and Methods: Seventy-one patients with MS underwent their first BTX-A injection for refractory NDO. They had clinical and urodynamic cystometry assessment before and three months after injection. The patients were divided in three groups according to treatment efficacy: full success (total urinary continence, no overactive detrusor), improvement, or total failure (urge incontinence and overactive detrusor). Results: 77% of the patients had clinical improvement or full success of the treatment with a reduction of their urgency and incontinence. Significant urodynamic improvement after treatment was shown on different parameters: volume at first involuntary bladder contraction (p = 0.0000001), maximum cystometric capacity (p = 0.0035), maximum detrusor pressure (p = 0.0000001). 46% of the patients were in the "full success" group. 31% of the patients had a partial improvement. 23% of the patients had no efficacy of the treatment. Duration of MS was a predictive factor of treatment failure (p = 0.015). Conclusions: Despite that a full success was obtained in 46% of the cases, BTX-A injection therapy failed to treat refractory NDO in 23% of patients suffering from MS. Duration of the disease was a predictive factor for an inefficient treatment. The injection therapy should be considered as soon as oral anticholinergic drugs fail to reduce NDO. Multiple sclerosis (MS) is a common demyelinating disease of the central nervous system. The lesions occur in different time and localization in subcortical areas, brain stem and spinal cord. The disease has varied clinical presentations (1). Bladder and urethra dysfunction are very common. Detrusor overactivity is the most common urodynamic sign. It is observed in 44% (2) to 81% (3) of patients. Detrusor sphincter dyssynergia is associated with overactive detrusor in 93% of cases (2).Detrusor overactivity is often associated with overactive bladder, defined by urgency, possibly associated with urge incontinence, daytime frequency, and nocturia (4). These symptoms significantly alter the quality of life (5). Urological complications including hydronephrosis, vesicoureteral reflux, urosepsis, and urolithiasis (6) occur in 12% of the patients who suffer from neurogenic detrusor overactivity (NDO) and MS (7). The rate NeurourologyInternational Braz J Urol

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Section: Discussionmentioning

confidence: 49%

“…Later examinations were not reported, as this study focuses on the response to the treatment. Urodynamic investigations were done complying with ICS recommendations (17).…”

Section: Discussionmentioning

confidence: 99%

“…The induced hypocontractility of the detrusor by the treatment led to urinary retention that often required intermittent self-catheterization (17).…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Botulinum toxin A for the treatment of neurogenic detrusor overactivity in multiple sclerosis patients

et al. 2011

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“…Although antimuscarinic drugs have been the current first-line pharmacotherapy for OAB, their persistence rates are low with less than 50 or 25% remaining on medication at 6 months or 1 year, respectively (Brostrøm and Hallas, 2009;Sexton et al, 2011;Chancellor et al, 2013). The high rate of discontinuing antimuscarinic drugs is considered to be attributable to the concurrence of many types of adverse effects such as dry mouth, constipation, blurred vision, voiding dysfunction, and tachycardia (Yarker et al, 1995;Kelleher et al, 1997;Andersson, 2004) as well as the lack of efficacy of antimuscarinic drugs, in part due to the atropine-resistant contraction of the urinary bladder (Kelleher et al, 1997;Sahai et al, 2005;Sakakibara et al, 2011). Therefore, the development of new therapeutic agents with a mode of action different from that of antimuscarinic drugs has been eagerly anticipated.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of TRK-130 (Naltalimide), a Novel Opioid Ligand, as a New Therapeutic Agent for Overactive Bladder

Fujimura

Izumimoto

Momen

et al. 2014

J Pharmacol Exp Ther

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We characterized 6R,14S)-17-(cyclopropylmethyl)-4,5-epoxy-3,14-dihydroxymorphinan-6-yl]phthalimide; naltalimide), an opioid ligand, to clarify the therapeutic potential for overactive bladder (OAB). In radioligand-binding assays with cells expressing human m-opioid receptors (MORs), d-opioid receptors (DORs), or k-opioid receptors (KORs), TRK-130 showed high selectivity for MORs (K i for MORs, DORs, and KORs 5 0.268, 121, and 8.97 nM, respectively). In a functional assay (cAMP accumulation) with cells expressing each human opioid receptor subtype, TRK-130 showed potent but partial agonistic activity for MORs [EC 50 (E max )

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Surgical management of functional bladder outlet obstruction in adults with neurogenic bladder dysfunction

Utomo¹,

Blok²

2011

Cochrane Database of Systematic Reviews

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Botulinum toxin for the treatment of lower urinary tract symptoms: A review

Abstract: Application of botulinum toxin in the lower urinary tract has produced promising results in treating lower urinary tract dysfunction, which needs further evaluation with randomised, placebo-controlled trials.

Cited by 54 publications

References 86 publications

Botulinum toxin A for the treatment of neurogenic detrusor overactivity in multiple sclerosis patients

Botulinum toxin A for the treatment of neurogenic detrusor overactivity in multiple sclerosis patients

Characteristics of TRK-130 (Naltalimide), a Novel Opioid Ligand, as a New Therapeutic Agent for Overactive Bladder

Surgical management of functional bladder outlet obstruction in adults with neurogenic bladder dysfunction

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