scholarly journals Botulinum toxin type A in the treatment of bladder pain syndrome in women: initial results

2018 ◽  
Vol 8 (2) ◽  
pp. 5-10
Author(s):  
Salman H Al-Shukri ◽  
Igor V Kuzmin ◽  
Margarita N Slesarevskaya ◽  
Yuriy A Ignashov

We present the results of botulinum toxin type A (BT-A) treatment in 49 women (aged 41-65 years) with bladder pain syndrome. Previously, all patients underwent oral and intravesical drug therapy in addition to hydrodistention of the bladder without significant clinical effect. BT-A at a dose of 100 U (20 points at 5 units) was injected into the bladder under general anesthesia. Treatment results were evaluated 3 months after the treatment using specialized questionnaires such as the Pelvic Pain and Urgency/Frequency (PUF) Scale, O’Leary-Sant Symptom Index and Interstitial Cystitis Scale, visual analogue pain scale (VAS), and urinary diaries. Remarkably, the treatment was effective in 46 (93.8%) patients. By the end of the third month after the BT-A injection, the PUF Scale score, the O’Leary-Sant Symptom and Interstitial Cystitis Scale, and VAS reduced by 41.3%, 32%, and 34%, respectively, and urination frequency decreased by 38.5%. Thus, BT-A is an effective method for treating bladder pain syndrome in patients who are refractory to other treatment methods. (For citation: Al-Shukri SH, Kuzmin IV, Slesarevskaya MN, Ignashov YuA. Botulinum toxin type A in the treatment of bladder pain syndrome in women: initial results. Urologicheskie vedomosti. 2018;8(2):5-10. doi: 10.17816/uroved825-10).

2021 ◽  
Author(s):  
Yongjae Yoo ◽  
Chang-Soon Lee ◽  
Jungsoo Kim ◽  
Dongwon Jo ◽  
Jee Youn Moon

Background The present study was designed to test the hypothesis that botulinum toxin would prolong the duration of a lumbar sympathetic block measured through a sustained increase in skin temperature. The authors performed a randomized, double-blind, controlled trial to investigate the clinical outcome of botulinum toxin type A for lumbar sympathetic ganglion block in patients with complex regional pain syndrome. Methods Lumbar sympathetic ganglion block was conducted in patients with lower-extremity complex regional pain syndrome using 75 IU of botulinum toxin type A (botulinum toxin group) and local anesthetic (control group). The primary outcome was the change in the relative temperature difference on the blocked sole compared with the contralateral sole at 1 postoperative month. The secondary outcomes were the 3-month changes in relative temperature differences, as well as the pain intensity changes. Results A total of 48 participants (N = 24/group) were randomly assigned. The change in relative temperature increase was higher in the botulinum toxin group than in the control group (1.0°C ± 1.3 vs. 0.1°C ± 0.8, respectively; difference: 0.9°C [95% CI, 0.3 to 1.5]; P = 0.006), which was maintained at 3 months (1.1°C ± 0.8 vs. –0.2°C ± 1.2, respectively; P = 0.009). Moreover, pain intensity was greatly reduced in the botulinum toxin group compared with the control group at 1 month (–2.2 ± 1.0 vs. –1.0 ± 1.6, respectively; P = 0.003) and 3 months (–2.0 ± 1.0 vs. –0.6 ± 1.6, respectively; P = 0.003). There were no severe adverse events pertinent to botulinum toxin injection. Conclusions In patients with complex regional pain syndrome, lumbar sympathetic ganglion block using botulinum toxin type A increased the temperature of the affected foot for 3 months and also reduced the pain. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New


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