Botulinum A toxin intravesical injections in the treatment of painful bladder syndrome: a pilot study.

Abstract

OBJECTIVE:

We evaluated the efficacy and tolerability of botulinum A toxin (BTX-A) intravesical injections in patients affected by painful bladder syndrome with increased urinary frequency, refractory to conventional treatment modalities.

METHODS:

Twelve women and two men were prospectively included in the study. Under short general anaesthesia patients were given injections of 200 U of commercially available BTX-A diluted in 20 ml 0.9% NaCl. Injections were performed submucosally in the trigone and bladder floor under cystoscopic control. Voiding chart, the Visual Analog Scale (VAS) for pain, and urodynamics were performed before treatment and 1 and 3 mo afterward.

RESULTS:

Overall, 12 patients (85.7%) reported subjective improvement at 1 and 3 mo follow-up. The mean VAS score was significantly reduced at 1 and 3 mo after treatment (p<0.05 for both); at the same time points daytime and nighttime urinary frequency significantly decreased (p<0.01 and p<0.05, respectively), and bladder cystometric capacity significantly increased (p<0.01). Two patients reported incomplete bladder emptying. We did not detect any systemic side effects during or after treatment.

CONCLUSIONS:

The results of this pilot study indicate that BTX-A intravesical injections are effective in the short-term management of painful bladder syndrome. By modulating afferent C-fiber activity within the bladder walls, BTX-A significantly improves urodynamic parameters and reduces bladder pain and urinary frequency.

• Authors: Antonella Giannantoni, Elisabetta Costantini, Savino M Di Stasi, Maria Cristina Tascini, Vittorio Bini, Massimo Porena
• Journal: European urology (Eur Urol) Vol. 49 Issue 4 Pg. 704-9 (Apr 2006) ISSN: 0302-2838 [Print] Switzerland
• PMID: 16417964 (Publication Type: Journal Article)

Chemical References

• Neuromuscular Agents
• Botulinum Toxins, Type A

Topics

• Administration, Intravesical
• Aged
• Botulinum Toxins, Type A (administration & dosage, therapeutic use)
• Cystitis, Interstitial (drug therapy)
• Female
• Humans
• Male
• Middle Aged
• Neuromuscular Agents (administration & dosage, therapeutic use)
• Pain Measurement
• Pilot Projects
• Prospective Studies
• Statistics, Nonparametric
• Treatment Outcome