RESEARCH: Experimental use of Botox to treat urinary disfunction in neuro disorders

May 26, 2004

Emerging role of botulinum toxin in the management of

voiding dysfunction.

CP, Chancellor MB.

Department of Urology, Baylor College of

Medicine, Houston, Texas, USA.

PURPOSE: In recent years there has been tremendous

excitement over the use of botulinum neurotoxin (BTX)

to treat various urethral and bladder dysfunctions.

BTX is the most potent, naturally occurring toxin

known to mankind. Why, then, would a urologist want to

use this agent to poison the bladder or urethral

sphincter? MATERIALS AND METHODS: We reviewed the

recent literature on the mechanisms underlying the

effects of BTX treatment and discuss current use of

this agent within the urological community, as well as

provide perspective on future targets of BTX. The

information was gathered from MEDLINE, abstracts from

recent urological meetings and personal experience.

RESULTS: Injection of BTX appears to have a positive

therapeutic effect in multiple urological conditions,

including detrusor hyperreflexia and detrusor external

sphincter dyssynergia, and nonneurogenic conditions

such as pelvic floor spasticity, refractory overactive

bladder and, possibly, benign prostatic hyperplasia.

Interstitial cystitis may even be potentially helped

with bladder BTX injection. CONCLUSIONS: Botulinum

toxin is a novel and promising treatment for a variety

of lower urinary tract dysfunctions. The basic science

behind its mechanism of action and physiology, and

published clinical results are impressive. However,

since application of BTX in the lower urinary tract

has not been approved by the Food and Drug

Administration, caution should be used until future

properly designed, multicenter randomized studies are

completed to assess the safety and efficacy of BTX in

urological diseases.

SOURCE: J Urol. 2004 Jun;171(6 Pt 1):2128-37.

5126771 & dopt=Abstract

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