Comparative study of efficacy and safety between bladder body and trigonal intravesical onabotulinumtoxina injection in the treatment of interstitial cystitis refractory to conventional treatment—A prospective, randomized, clinical trial

Jiang, Yuan‐Hong; Jhang, Jia‐Fong; Lee, Cheng‐Ling; Kuo, Hann‐Chorng

doi:10.1002/nau.23475

Cited by 13 publications

(15 citation statements)

References 29 publications

(36 reference statements)

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“…After eight weeks from baseline, they showed no significant difference in changes in urinary frequency, voided volume, post-void residual volume, and bladder capacity. No significant difference in decreasing VAS, symptom improvement, and dysuria were also noted [48].…”

Section: Clinical Application Of Bont-a In Ic/bps Womenmentioning

confidence: 90%

Can Botulinum Toxin A Play a Role in Treatment of Chronic Pelvic Pain Syndrome in Female Patients?—Clinical and Animal Evidence

Chen

Meng

2020

Toxins

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Chronic pelvic pain (CPP) is defined as chronic pain and inflammation in the pelvic organs for more than six months. There are wide ranges of clinical presentations, including pelvic pain, painful intercourse, irritable bowel syndrome, and pain during urinating. Chronic pelvic pain syndrome (CPPS) is a subdivision of CPP, and the pain syndrome may be focused within a single organ or more than one pelvic organ. As there is uncertain pathogenesis, no standard treatment is currently available for CPPS. Botulinum toxin A (BoNT-A) is a potent neurotoxin that blocks acetylcholine release to paralyze muscles. Intravesical BoNT-A injection can reduce bladder pain in patients with interstitial cystitis/bladder pain syndrome. BoNT-A injected into the pelvic floor muscles of women has also been reported to improve chronic pain syndrome. Due to the reversible effect of BoNT-A, repeated injection appears to be necessary and effective in reducing symptoms. Adverse effects of BoNT-A may worsen the preexisting conditions, including constipation, stress urinary incontinence, and fecal incontinence. This review summarizes the evidence of BoNT-A treatment for CPPS in animal studies and clinical studies regarding the therapeutic effects of BoNT-A for CPPS in female patients.

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Section: Clinical Application Of Bont-a In Ic/bps Womenmentioning

confidence: 90%

Can Botulinum Toxin A Play a Role in Treatment of Chronic Pelvic Pain Syndrome in Female Patients?—Clinical and Animal Evidence

Chen

Meng

2020

Toxins

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“…The think‐tank review concluded that BONT‐A did not produce consistent efficacy in the treatment of BPS/IC due to the absence of a well‐conducted randomized controlled trial. One recent study has found no significant difference in the improvement of symptoms and urodynamic parameters after injection in the bladder dome or trigone and adverse events were similar . Another recent study found that trigonal BONT‐A injection caused significant and clinically relevant improvements in bladder pain and quality of life when compared to saline injection …”

Section: Botulinum Toxin Treatment For Bpsmentioning

confidence: 99%

How can we improve the diagnosis and management of bladder pain syndrome? Part 2:ICI‐RS 2018

Khullar

Digesu

Veit‐Rubin

et al. 2019

Neurourology and Urodynamics

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Background: This paper summarises the discussion in a think tank at the International Consultation on Incontinence-Research Society (ICI-RS) 2018 about the treatment of bladder pain syndrome.Aims: To review the treatments of bladder pain syndrome from behavioural treatments to surgical interventions.Materials and Methods: Review the literature in the light of the think tank discussions. Results: All guidelines recommend different levels of treatment starting with conservative behavioral treatments then introducing oral treatments followed by intravesical instillations. If these treatments fail then more invasive treatments such as botulinum toxin injections, neuromodulation, or surgery could be suggested. Conclusion: Unfortunately for all treatments, the numbers are limited and, therefore, the evidence base is not strong. Further suggestions for research are suggested.

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“…We included eight studies investigating the role of BTX-A in the context of IC/BPS, 5 RCT and three comparative studies [10][11][12][13][14][15][16][17] (Supplementary Table S2). Overall participants included 319 patients.…”

Section: Bladder Pain Syndrome/interstitial Cystitismentioning

confidence: 99%

“…The intervention and control groups differed greatly among the studies included. One study compared intradetrusorial BTX-A injections and hydrodistension (HD) with placebo (normal saline injections) and HD [10], one compared BTX-A immediate versus delayed (after one month) injections [11], and two evaluated the differences between sub-urothelial BTX-A injections using a 'trigonal template' against a 'bladder-body/trigone sparing template' [12,13]. Another RCT compared intradetrusorial BTX-A injections with intravesical instillation of Bacille Calmette-Guerin (BCG) [14].…”

Section: Bladder Pain Syndrome/interstitial Cystitismentioning

confidence: 99%

Botulinum Toxin-A Injection in Chronic Pelvic Pain Syndrome Treatment: A Systematic Review and Pooled Meta-Analysis

Panunzio

Tafuri

Mazzucato

et al. 2022

Toxins

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Introduction: Pain management of patients with chronic pelvic pain syndrome (CPPS) is challenging, because pain is often refractory to conventional treatments. Botulinum toxin A (BTX-A) may represent a promising therapeutic strategy for these patients. The aim of this systematic review was to investigate the role of BTX-A in CPPS treatment. Methods: We reviewed the literature for prospective studies evaluating the use of BTX-A in the treatment of CPPS. A comprehensive search in the PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials databases was performed from English language articles published between January 2000 and October 2021. The primary outcome was to evaluate pain improvement in CPPS after BTX-A treatment. Pooled meta-analysis of the included studies, considering the effect of BTX-A on pain evaluated at last available follow-up compared to baseline values, was performed together with meta-regression analysis. Results: After screening 1001 records, 18 full-text manuscripts were selected, comprising 13 randomized clinical trials and five comparative studies. They covered overall 896 patients of both sexes and several subtype of CPPS (interstitial cystitis/bladder pain syndrome, chronic prostatitis/prostate pain syndrome, chronic scrotal pain, gynecological pelvic pain, myofascial pelvic pain). The clinical and methodological heterogeneity of studies included makes it difficult to do an overall estimation of the real effect of BTX-A on pain and other functional outcomes of various CPPS subtypes. However, considering pooled meta-analysis results, a benefit in pain relief was showed for BTX-A-treated patients both in the overall studies populations and in the overall cohorts of patients with CPP due to bladder, prostate, and gynecological origin. Conclusions: BTX-A could be an efficacious treatment for some specific CPPS subtypes. Higher level studies are needed to assess the efficacy and safety of BTX-A and provide objective indications for its use in CPPS management.

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Comparative study of efficacy and safety between bladder body and trigonal intravesical onabotulinumtoxina injection in the treatment of interstitial cystitis refractory to conventional treatment—A prospective, randomized, clinical trial

Abstract: No significant difference in the improvement of IC symptoms and urodynamic parameters after intravesical BoNT-A injection in the bladder body or trigone. The rate of adverse events was similar between groups.

Cited by 13 publications

References 29 publications

Can Botulinum Toxin A Play a Role in Treatment of Chronic Pelvic Pain Syndrome in Female Patients?—Clinical and Animal Evidence

Can Botulinum Toxin A Play a Role in Treatment of Chronic Pelvic Pain Syndrome in Female Patients?—Clinical and Animal Evidence

How can we improve the diagnosis and management of bladder pain syndrome? Part 2:ICI‐RS 2018

Botulinum Toxin-A Injection in Chronic Pelvic Pain Syndrome Treatment: A Systematic Review and Pooled Meta-Analysis

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