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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
Review

Abstract

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.

Methods

Randomised controlled trials (RCTs) and prospective studies of relevance were identified, assessed for inclusion and then analysed by two independent reviewers.

Results

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).

Conclusions

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.

Keywords

Botulinum toxin Interstitial cystitis Intravesical injection Bladder pain syndrome 

Abbreviations

BPS

Bladder pain syndrome

PBS

Painful bladder syndrome

IC

Interstitial cystitis

RCT

Randomised controlled trial

BFLUTS

Bristol Female Lower Urinary Tract Symptoms Questionnaire

GRA

Global Response Assessment

IIQ

Incontinence Impact Questionnaire

ICSI

Interstitial Cystitis Symptom Index

ICPI

Interstitial Cystitis Problem Index

KHQ

King's Health Questionnaire

QoL

Quality of life

IPPS

International Prostate Symptom Score

UDI

Urogenital Distress Inventory

VAS

Visual Analogue Score

MCC

Maximum cystometric capacity

FDV

First desire to void

Notes

Acknowledgements

Derick Yates, medical librarian at BWHFT, did the literature search for us.

Conflicts of interest

None.

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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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