Journal of Neural Transmission

, Volume 115, Issue 4, pp 593–605

The use of botulinum neurotoxin type A (BoNTA) in urology


DOI: 10.1007/s00702-007-0862-x

Cite this article as:
Apostolidis, A. & Fowler, C. J Neural Transm (2008) 115: 593. doi:10.1007/s00702-007-0862-x


The use of Botulinum neurotoxin type A (BoNT/A) in the lower urinary tract was pioneered as early as 20 years ago with injections into the urethral sphincter reducing bladder voiding pressures, urethral pressures, and post-void residual urine. Over the past 9 years, the use of BoNT/A has revolutionised the treatment of intractable symptoms associated with the neurogenic or idiopathic overactive bladder, both in adults and children. The duration of clinical improvement is 6–11 months, is accompanied by significant amelioration of patients’ quality of life and repeat bladder treatments appear to have sustained effects. Despite evidence for an effect on the afferent pathways, its mode of action in the human bladder remains largely unknown. The use of BoNT/A has also expanded into the painful bladder syndrome and in benign prostatic diseases, with promising preliminary results.

This review aims to provide an insight of the use of BoNT/A in the lower urinary tract, addressing issues such as treatment outcomes and safety, mechanisms of action and potential for future research.

Keywords: Botulinum toxin; overactive bladder; detrusor overactivity; hyperreflexia; detrusor-sphincter dyssynergia; painful bladder; prostate 

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  1. 1.Institute of Neurology, University College London, and The National Hospital for Neurology and NeurosurgeryUniversity College London HospitalsLondonUK
  2. 2.2nd Department of Urology, Papageorgiou HospitalAristotle University of ThessalonikiThessalonikiGreece

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