Intravesical botulinum toxin A injections in the treatment of painful bladder syndrome/interstitial cystitis: a systematic review

Tirumuru, Sahithi; Al‐Kurdi, Deyaa; Latthe, Pallavi

doi:10.1007/s00192-010-1162-9

Cited by 37 publications

(22 citation statements)

References 20 publications

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“…Recently, intravesical injection of BoNT-A has been introduced as a new treatment modality. 2 Repeated injections of BoNT-A are known to provide better therapeutic effects and long-term success rates than a single injection. 3 However, the efficacy of this treatment is still controversial, partly because of a limited number of RCT.…”

Section: Introductionmentioning

confidence: 99%

Botulinum toxin type A injection for refractory interstitial cystitis: A randomized comparative study and predictors of treatment response

et al. 2015

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Objectives: To determine whether botulinum toxin type A can represent an alternative treatment option for patients with interstitial cystitis refractory to conventional therapies. Methods: This is a single-center, prospective, open labeled, randomized comparative study. Patients with refractory interstitial cystitis were randomly divided into two groups: immediate injection (group A) or 1-month delayed injection (group B) of botulinum toxin type A after allocation. The rate of treatment response (global response assessment ≥+1: slightly improved), and changes in symptom scores and frequency volume chart variables were compared between groups 1 month after allocation. Using subjects of both groups as a single cohort, predictive factors for treatment response at 1 month post-injection and the duration of response were explored. Results: A total of 34 patients (group A n = 18, group B n = 16) were allocated. The response rate was significantly higher in group A than group B (72.2% vs 25.0%, P = 0.01). All symptom measures showed significant improvement in group A than group B. When both groups were combined as a single cohort, the response rate was 73.5% at 1 month, 58.8% at 3 months, 38.2% at 6 months and 20.6% at 12 months. The mean duration of response was 5.4 months. Multivariate analysis showed that past exposure to hydrodistension more than three times correlated with better outcomes. Conclusions: Botulinum toxin type A injection could be an alternative treatment option for patients with interstitial cystitis refractory to conventional therapies, especially for those who have received repeated hydrodistensions and transurethral fulguration.

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Section: Introductionmentioning

confidence: 99%

Botulinum toxin type A injection for refractory interstitial cystitis: A randomized comparative study and predictors of treatment response

et al. 2015

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“…Tirumuru et al suggested that BoNTA might show a trend toward short-term benefit on urodynamic parameters based on RCTs [6]. Giannantoni et al proposed a comprehensive IC/PBS treatment strategy, such as oral medication, intravesical instillations, and combined treatment, but the results obtained had high heterogeneity, with uncertain conclusions [14].…”

Section: Discussionmentioning

confidence: 99%

“…There are numerous treatments for IC/PBS, including diet therapy, behavior adjustment training (BAT), oral medication, intravesical instillation, and surgical intervention [6].…”

Section: Introductionmentioning

confidence: 99%

Intravesical treatment for interstitial cystitis/painful bladder syndrome: a network meta-analysis

et al. 2016

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Introduction and hypothesis Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic inflammatory condition of the submucosal and muscular layers of the bladder. So far, there is no effective and targeted treatment strategy for IC/ PBS. This study aimed to assess the efficacy and safety of intravesical instillation treatment in IC/PBS patients. Methods We searched various databases up to October 2015. A network meta-analysis was performed to compare global response assessment (GRA) for different treatment strategies, including botulinum toxin A (BoNTA), bacillus CalmetteGuerin (BCG), resiniferatoxin (RTX), lidocaine, chondroitin sulfate (CS), oxybutynin, and pentosan polysulfate (PPS). A traditional meta-analysis was also performed. Results Sixteen trials evaluating 905 patients were included. Network meta-analysis indicated that BoNTA had the highest probability of being the best treatment course according to GRA assessment results (probability 81.7 %). BCG or BoNTA therapy yielded significant improvement in GRA incidence according to traditional meta-analysis. Patients who received PPS showed higher urinary frequency results compared with the placebo groups. BCG-and PPS-treated patients had elevated urinary urgency treatment effects compared with placebo groups. Bladder capacity restoration results also showed significant improvements in patients who received BoNTA compared with placebo-treated individuals. Conclusions These findings indicate that BoNTA therapy has the highest probability of being the best therapy according to GRA, and significantly improves bladder capacity in IC/PBS patients. BCG treatment also significantly increases the incidence of GRA and improves the symptoms of urinary urgency. PPS can significantly improve urinary frequency and urgency symptoms in IC/PBS patients.

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“…Recent studies have additionally shown an anti-inflammatory effect and reduction of substance P in the urine following intradetrusor BTX-A injection. 19,20 Sacral nerve stimulation (SNS) is not widely available. It involves placing a lead into sacral foramen S3, connected to an implantable neurostimulator under the skin just above the sacrum.…”

Section: Surgical Optionsmentioning

confidence: 99%

The challenge of bladder pain syndrome

Alnajjar¹,

Biers²

2017

Trends Urology & Men Health

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Intravesical botulinum toxin A injections in the treatment of painful bladder syndrome/interstitial cystitis: a systematic review

Cited by 37 publications

References 20 publications

Botulinum toxin type A injection for refractory interstitial cystitis: A randomized comparative study and predictors of treatment response

Botulinum toxin type A injection for refractory interstitial cystitis: A randomized comparative study and predictors of treatment response

Intravesical treatment for interstitial cystitis/painful bladder syndrome: a network meta-analysis

The challenge of bladder pain syndrome

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