Neurourology pp 277-279 | Cite as

Intravesical Drug Therapy

  • J. Todd PurvesEmail author


First line therapy for detrusor overactivity in patients with neurogenic bladder consists of oral agents, most commonly antimuscarinics. However, many patients suffer from severe side effects such as dry mouth, constipation and heat intolerance and therefore cannot tolerate the systemic administration of these agents. Intravesical administration, which is simply introducing the drug directly into the bladder through a catheter, attempts to maximize the local action of the medication while limiting the systemic absorption and thereby decreasing the emergence and/or severity of side effects.


  1. 1.
    Krause P, Fuhr U, Schnitker J, Albrecht U, Stein R, Rubenwolf P. Pharmacokinetics of intravesical versus oral oxybutynin in healthy adults: results of an open label, randomized, prospective clinical study. J Urol. 2013;190:1791–7.CrossRefGoogle Scholar
  2. 2.
    Williams NA, Lee KM, Allender CJ, Bowen JL, Gumbleton M, Harrah T, et al. Investigating detrusor muscle concentrations of oxybutynin after intravesical delivery in an ex vivo porcine model. J Pharm Sci. 2015;104:2233–40.CrossRefGoogle Scholar
  3. 3.
    Schroder A, Albrecht U, Schnitker J, Reitz A, Stein R. Efficacy, safety, and tolerability of intravesically administered 0.1% oxybutynin hydrochloride solution in adult patients with neurogenic bladder: a randomized, prospective, controlled multi-center trial. Neurourol Urodyn. 2016;35:582–8.CrossRefGoogle Scholar
  4. 4.
    Chancellor M, Boone T. Anticholinergics for overactive bladder therapy: central nervous system effects. CNS Neurosci Ther. 2012;18:167–74.CrossRefGoogle Scholar
  5. 5.
    Humblet M, Verpoorten C, Christiaens MH, Hirche H, Jansen K, Buyse G, et al. Long-term outcome of intravesical oxybutynin in children with detrusor-sphincter dyssynergia: with special reference to age-dependent parameters. Neurourol Urodyn. 2015;34:336–42.CrossRefGoogle Scholar
  6. 6.
    Fraser MO, Chuang YC, Tyagi P, Yokoyama T, Yoshimura N, Huang L, et al. Intravesical liposome administration–a novel treatment for hyperactive bladder in the rat. Urology. 2003;61:656–63.CrossRefGoogle Scholar
  7. 7.
    Chuang YC, Tyagi P, Huang CC, Yoshimura N, Wu M, Kaufman J, et al. Urodynamic and immunohistochemical evaluation of intravesical botulinum toxin a delivery using liposomes. J Urol. 2009;182:786–92.CrossRefGoogle Scholar
  8. 8.
    Kuo HC, Liu HT, Chuang YC, Birder LA, Chancellor MB. Pilot study of liposome-encapsulated onabotulinumtoxina for patients with overactive bladder: a single-center study. Eur Urol. 2014;65:1117–24.CrossRefGoogle Scholar
  9. 9.
    Chuang YC, Kaufmann JH, Chancellor DD, Chancellor MB, Kuo HC. Bladder instillation of liposome encapsulated onabotulinumtoxina improves overactive bladder symptoms: a prospective, multicenter, double-blind, randomized trial. J Urol. 2014;192:1743–9.CrossRefGoogle Scholar
  10. 10.
    Kajbafzadeh AM, Montaser-Kouhsari L, Ahmadi H, Sotoudeh M. Intravesical electromotive botulinum toxin type a administration: part I–experimental study. Urology. 2011;77:1460–4.CrossRefGoogle Scholar
  11. 11.
    Kajbafzadeh AM, Ahmadi H, Montaser-Kouhsari L, Sharifi-Rad L, Nejat F, Bazargan-Hejazi S. Intravesical electromotive botulinum toxin type a administration–part II: clinical application. Urology. 2011;77:439–45.CrossRefGoogle Scholar
  12. 12.
    Tyagi P, Kashyap M, Hensley H, Yoshimura N. Advances in intravesical therapy for urinary tract disorders. Expert Opin Drug Deliv. 2016;13:71–84.CrossRefGoogle Scholar
  13. 13.
    Giannantoni A, Di Stasi SM, Stephen RL, Bini V, Costantini E, Porena M. Intravesical resiniferatoxin versus botulinum-a toxin injections for neurogenic detrusor overactivity: a prospective randomized study. J Urol. 2004;172:240–3.CrossRefGoogle Scholar

Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Duke University Medical CenterDurhamUSA

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