International Urogynecology Journal

, Volume 21, Issue 10, pp 1285–1300 | Cite as

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

  • Sahithi Tirumuru
  • Deyaa Al-Kurdi
  • Pallavi Latthe


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.


Botulinum toxin Interstitial cystitis Intravesical injection Bladder pain syndrome 



Bladder pain syndrome


Painful bladder syndrome


Interstitial cystitis


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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Copyright information

© The International Urogynecological Association 2010

Authors and Affiliations

  • Sahithi Tirumuru
    • 1
  • Deyaa Al-Kurdi
    • 1
  • Pallavi Latthe
    • 1
  1. 1.Birmingham Women’s NHS Foundation TrustBirminghamUK

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