Intravesical Injection of Botulinum Toxin

Toxins ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 676 ◽  
Author(s):  
Hsiu-Jen Wang ◽  
Wan-Ru Yu ◽  
Hueih-Ling Ong ◽  
Hann-Chorng Kuo

A botulinum toxin A (BoNT-A) intravesical injection can improve the symptoms of interstitial cystitis/bladder pain syndrome (IC/BPS). Patients with IC/BPS have different clinical characteristics, urodynamic features, and cystoscopic findings. This study assessed the treatment outcomes of a BoNT-A intravesical injection and aimed to identify the predictive factors of a satisfactory outcome. This retrospective study included IC/BPS patients treated with 100 U BoNT-A. The treatment outcomes were assessed by global response assessment (GRA) at 6 months. We classified patients according to different clinical, urodynamic, and cystoscopic characteristics and evaluated the treatment outcomes and predictive factors. A total of 238 patients were included. Among these patients, 113 (47.5%) had a satisfactory outcome (GRA ≥ 2) and 125 (52.5%) had an unsatisfactory outcome. Improvements in the IC symptom score, IC problem score, O’Leary–Sant symptom score, and visual analog scale score for pain were significantly greater in patients with a satisfactory outcome than in patients with an unsatisfactory outcome (all p = 0.000). The IC disease duration and maximal bladder capacity (MBC) were significantly different between patients with and without a satisfactory outcome. Multivariate analysis revealed that only the MBC was a predictor for a satisfactory outcome. Patients with a MBC of ≥760 mL and glomerulations of 0/1 (58.7%) or glomerulations of 2/3 (75.0%) frequently had a satisfactory outcome. We found that BoNT-A intravesical injection can effectively improve symptoms among patients with IC/BPS, with a remarkable reduction in bladder pain. A MBC of ≥760 mL is a predictive factor for a satisfactory treatment outcome.


Urology ◽  
2006 ◽  
Vol 68 (5) ◽  
pp. 1091-1096 ◽  
Author(s):  
Abdol-Mohammad Kajbafzadeh ◽  
Shahram Moosavi ◽  
Parvin Tajik ◽  
Hamid Arshadi ◽  
Seyedmehdi Payabvash ◽  
...  

Toxins ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 166 ◽  
Author(s):  
Yuan-Hong Jiang ◽  
Wan-Ru Yu ◽  
Hann-Chorng Kuo

Bladder oversensitivity arises from several different conditions involving the bladder, bladder outlet, systemic or central nervous system diseases. Increase of the bladder sensation results from activation of the sensory receptors in the urothelial cells or suburothelial tissues. Medical treatment targeting the overactive bladder (OAB) or interstitial cystitis (IC) might relieve oversensitive bladder symptoms (frequency, urgency and pain) in a portion of patients, but a certain percentage of patients still need active management. Botulinum toxin A (BoNT-A) has been demonstrated to have anti-inflammatory and antinociceptive effects in bladder sensory disorders and has been shown effective in the reduction of bladder oversensitivity and the increase of functional bladder capacity. For patients with OAB, urgency and urinary incontinence improved, while in patients with IC, bladder pain could be relieved in association with reduction of bladder oversensitivity after BoNT-A intravesical injection. Histological evidence has confirmed the therapeutic mechanism and clinical efficacy of intravesical BoNT-A injection on patients with OAB or IC. Bladder oversensitivity can also be relieved with the instillation of liposome encapsulated BoNT-A or low energy show waves (LESWs), which enable the BoNT-A molecule to penetrate into the urothelium and suburothelial space without affecting the detrusor contractility. Liposome encapsulated BoNT-A or combined LESWs and BoNT-A instillation might be future treatment alternatives for bladder oversensitivity in sensory bladder disorders.


2005 ◽  
Vol 17 (5) ◽  
pp. 512-518 ◽  
Author(s):  
Mat H Ho ◽  
Lawrence L Lin ◽  
Alexandra L Haessler ◽  
Narender N Bhatia

Urology ◽  
2020 ◽  
Vol 142 ◽  
pp. 190-194 ◽  
Author(s):  
Seyedeh-Sanam Ladi-Seyedian ◽  
Lida Sharifi-Rad ◽  
Abdol-Mohammad Kajbafzadeh

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