Intravesical botulinum toxin A injections in the treatment of painful bladder syndrome/interstitial cystitis: a systematic review
Introduction and hypothesis
Intravesical botulinum toxin A (BTX-A) is emerging as a potential new treatment for refractory interstitial cystitis (IC). However, there has been conflicting evidence on this treatment's effectiveness. The aim of our systematic review was to assess the effectiveness and adverse effects of intravesical BTX-A in IC.
Randomised controlled trials (RCTs) and prospective studies of relevance were identified, assessed for inclusion and then analysed by two independent reviewers.
Ten (three RCTs and seven prospective cohort) studies with a total of 260 participants were included. Eight studies reported improvement in symptoms. Urodynamic parameters were variable. Meta-analysis was not performed due to heterogeneity in reporting of outcomes. Some adverse events, e.g. dysuria and voiding difficulty, were noted (19 out of 260 were required to self-catheterise at anytime postoperatively).
The evidence from the studies thus far suggests a trend towards short-term benefit with intravesical BTX-A injections in refractory IC, but further robust evidence should be awaited.
KeywordsBotulinum toxin Interstitial cystitis Intravesical injection Bladder pain syndrome
Bladder pain syndrome
Painful bladder syndrome
Randomised controlled trial
Bristol Female Lower Urinary Tract Symptoms Questionnaire
Global Response Assessment
Incontinence Impact Questionnaire
Interstitial Cystitis Symptom Index
Interstitial Cystitis Problem Index
King's Health Questionnaire
Quality of life
International Prostate Symptom Score
Urogenital Distress Inventory
Visual Analogue Score
Maximum cystometric capacity
First desire to void
Derick Yates, medical librarian at BWHFT, did the literature search for us.
Conflicts of interest
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