Long-term botulinum therapy for overactive bladder: myths and reality

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The article provides an overview of modern approaches to pharmacotherapy of overactive bladder. It has been shown that the choice of drug therapy for overactive bladder should be made taking into account the pathophysiological mechanisms of the development of the disease, the characteristics of its clinical course, as well as the potential risks of developing side effects of treatment. A pathogenetic rationale for the choice of treatment tactics for different categories of patients is presented, including those with a hypersensitive bladder, bladder outlet obstruction, neurological and geriatric patients. The pharmacological properties of the 3-adrenergic receptor agonist mirabegron are described, which provide high efficacy and a favorable safety profile in the treatment of patients with overactive bladder. The practical issues of prescribing mirabegron in various clinical situations are considered.

Personalized approach to pharmacotherapy of overactive bladder

Kuzmin

2023

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Overactive bladder, inflammation and urinary tract infection: pathogenetic parallels

Kuzmin,

Slesarevskaya,

Romikh

2024

The review is devoted to modern ideas about the role of inflammation and urinary tract infection in the pathogenesis of overactive bladder. The molecular mechanisms of the mechanosensory function of the urothelium and the influence of bacterial colonization of the urothelium on it are described in detail. It has been shown that infectious inflammation, even in the absence of clinical symptoms, enhances the urothelial response to stretching and increases the excitability of afferent nerves. Bladder hypersensitivity and increased detrusor activity are pathogenetic basis for the development of overactive bladder. Data on the relationship between urinary infection and refractory overactive bladder are presented. The feasibility of conducting extended microbiological studies in patients with overactive bladder , especially when standard therapy is ineffective, has been demonstrated. A pathogenetic rationale for prescribing anti-inflammatory and immunoactive drugs to patients with overactive bladder is presented.

Botulinum toxin therapy in urology: historical aspect

Krivoborodov,

Kuzmin,

Slesarevskaya

et al. 2024

The review article shows the main stages of studying botulinum toxin and its use in medicine. The possibilities of using botulinum toxin for the treatment of urological patients are similarly described. Furthermore, the most significant studies on the use of botulinum toxin in patients with neurogenic detrusor c, idiopathic overactive bladder, detrusor sphincter dyssynergia, chronic pelvic pain, benign prostatic hyperplasia, erectile dysfunction, and premature ejaculation are presented.