[Intravesical instillations of capsaicin in urology: from pharmacological principles to therapeutic applications].

Abstract

Capsaicin is a specific neurotoxin for type C nonmyelinated vesical afferent fibres involved in the transmission of nociceptive stimuli and reorganization of voiding reflexes in disease. The presence of afferents sensitive to vanilloid substances in the human bladder suggests the potential value of intravesical instillations of capsaicin in patients with symptoms of bladder hypersensitivity or bladder hyperactivity. Ten clinical trials document the efficacy and safety of vesical instillation of capsaicin in 200 patients with neurological or non-neurological lower urinary tract symptoms. The objective of this review is to analyse these various publications in order to define the indications and practical conditions of intravesical instillation of capsaicin. The value of intravesical capsaicin in neurogenic bladder hyperactivity has been clearly demonstrated. In non-neurological indications, the diversity of instillation protocols and the heterogeneity of the evaluation parameters complicate analysis of the results. Repeated low-dose capsaicin appears to be useful in bladder hyperactivity, but the value of capsaicin is uncertain in idiopathic detrusor instability. Transient adverse effects are almost systematically observed after intravesical capsaicin. The short-term and medium-term local histological safety appears to be satisfactory, but needs to be documented in the long-term.

• Authors: M de Sèze, L Wiart, J M Ferrière, M P de Sèze, P A Joseph, M Barat
• Journal: Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie (Prog Urol) Vol. 9 Issue 4 Pg. 615-32 (Sep 1999) ISSN: 1166-7087 [Print] France
• Vernacular Title: Instillations intravésicales de capsaïcine en urologie. Des principes pharmacologiques aux applications thérapeutiques.
• PMID: 10555213 (Publication Type: Comparative Study, English Abstract, Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Capsaicin

Topics

• Administration, Intravesical
• Adolescent
• Adult
• Aged
• Animals
• Capsaicin (administration & dosage, pharmacology)
• Cats
• Clinical Trials as Topic
• Data Interpretation, Statistical
• Drug Tolerance
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Pain (etiology)
• Rats
• Time Factors
• Urinary Bladder (drug effects, innervation)
• Urinary Bladder Diseases (drug therapy, physiopathology)
• Urinary Bladder, Neurogenic (drug therapy, physiopathology)
• Urinary Incontinence (drug therapy, physiopathology)
• Urodynamics