Role of botulinum toxin-A in refractory idiopathic overactive bladder patients without detrusor overactivity

Kanagarajah, Prashanth; Ayyathurai, Rajinikanth; Caruso, Daniel; Gomez, Christopher; Gousse, Angelo E.

doi:10.1007/s11255-011-9979-9

Cited by 24 publications

(27 citation statements)

References 25 publications

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“…Successful treatment of OAB syndrome with botulinum toxin A does not appear to be related to the existence of detrusor overactivity. No differences in outcomes were found between those with and those without baseline detrusor overactivity 68,69…”

Section: Botulinum Toxinmentioning

confidence: 97%

New developments in the management of overactive bladder: focus on mirabegron and onabotulinumtoxinA

Andersson¹

2013

TCRM

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In the last few years, much new information has been generated on the pathophysiology, possible therapeutic targets, and pharmacologic treatment of overactive bladder (OAB). Antimuscarinic drugs are still first-line pharmacologic treatment for OAB and often have good initial response rates, but adverse effects and decreasing efficacy cause long-term compliance problems, prompting a search for new therapeutic alternatives. Mirabegron and onabotulinumtoxinA, two drugs with different mechanisms of action, and with adverse effect profiles different from those of antimuscarinics, were recently approved for treatment of OAB. However, their place in the treatment of this disorder has not yet been established. In this short review, the mechanisms of action, clinical efficacy, and safety profiles of these drugs are discussed and compared with those of the current gold standard, antimuscarinic agents.

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Section: Botulinum Toxinmentioning

confidence: 97%

New developments in the management of overactive bladder: focus on mirabegron and onabotulinumtoxinA

Andersson¹

2013

TCRM

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“…OnabotulinumtoxinA doses of more than 150 U were more commonly associated with PVR volume of more than 200 U 51 . Intravesical BoNT‐A injections were also shown to be effective in patients with refractory OAB without DO 10,52 . However, although repeated 100 U onabotulinumtoxinA injections are safe and effective in treating patients with OAB, certain patients will benefit from dose optimization to improve efficacy or prevent voiding dysfunction 53 …”

Section: Bont‐a Injections For Overactive Bladdermentioning

confidence: 99%

Botulinum toxin injection for lower urinary tract dysfunction

Kuo

2012

Int J of Urology

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Abbreviations & Acronyms 5ARI = 5-alpha-reductase inhibitor Ach = acetylcholine AD = autonomic dysreflexia ATP = adenosine triphosphate BCG = bacillus Calmette-Guérin BoNT = botulinum toxin BoNT-A = botulinum toxin type A BOO = bladder outlet obstruction BPH = benign prostatic hyperplasia CGRP = calcitonin gene-related peptide Abstract: Botulinum toxin has been recently accepted as a novel treatment for lower urinary tract dysfunctions refractory to conventional treatment. Review of the clinical trials in recent years, botulinum toxin type A has been widely used in the urethra or urinary bladder to treat voiding dysfunction due to detrusor sphincter dyssynergia, incontinence due to neurogenic or idiopathic detrusor overactivity, sensory disorders such as bladder hypersensitivity, overactive bladder, and interstitial cystitis/painful bladder syndrome. Intravesical botulinum toxin type A injection is effective in treatment of urinary incontinence due to detrusor overactivity in men and women, as well as in children. Currently botulinum toxin type A has also been applied to treat lower urinary tract symptoms due to benign prostatic hyperplasia in patients not suitable for surgery. This article reviewed the recent advances of botulinum toxin type A on lower urinary tract dysfunction.

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“…However, successful OAB treatment with BoNT‐A does not appear to be related to the existence of DO. No differences in outcomes were found between those with and those without baseline DO . BoNT‐A is also effective in patients with OAB syndrome not responding to antimuscarinic drugs …”

Section: Pharmacological Control Of Bladder Afferent Nerve Activitymentioning

confidence: 94%

“…69,70 BoNT-A is also effective in patients with OAB syndrome not responding to antimuscarinic drugs. 69,70 The major adverse effects are urinary retention, sometimes requiring clean intermittent catherization, and urinary tract infections. Beneficial effects were shown not to be dose-dependent, whereas side effects might be lessened at lower doses.…”

Section: Botulinum Toxinmentioning

confidence: 99%

Common theme for drugs effective in overactive bladder treatment: Inhibition of afferent signaling from the bladder

Hood

Andersson

2012

Int J of Urology

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The overactive bladder syndrome and detrusor overactivity are conditions that can have major effects on quality of life and social functioning. Antimuscarinic drugs are still first-line treatment. These drugs often have good initial response rates, but adverse effects and decreasing efficacy cause long-term compliance problems, and alternatives are needed. The recognition of the functional contribution of the urothelium/suburothelium, the autonomous detrusor muscle activity during bladder filling and the diversity of nerve transmitters involved has sparked interest in both peripheral and central modulation of overactive bladder syndrome/detrusor overactivity pathophysiology. Three drugs recently approved for treatment of overactive bladder syndrome/detrusor overactivity (mirabegron, tadalafil and onabotulinum toxin A), representing different pharmacological mechanisms; that is, β-adrenoceptor agonism, phosphodiesterase type 5 inhibition, and inhibition of nerve release of efferent and afferent transmitters, all seem to have one effect in common: inhibition of the afferent nervous activity generated by the bladder during filling. In the present review, the different mechanisms forming the pharmacological basis for the use of these drugs are discussed.

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Role of botulinum toxin-A in refractory idiopathic overactive bladder patients without detrusor overactivity

Abstract: Refractory idiopathic OAB patients without DOA on urodynamics may benefit from intradetrusor BTX-A.

Cited by 24 publications

References 25 publications

New developments in the management of overactive bladder: focus on mirabegron and onabotulinumtoxinA

New developments in the management of overactive bladder: focus on mirabegron and onabotulinumtoxinA

Botulinum toxin injection for lower urinary tract dysfunction

Common theme for drugs effective in overactive bladder treatment: Inhibition of afferent signaling from the bladder

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