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Botulinum Toxin in Treatment of Bladder Pain Syndrome/Interstitial Cystitis

  • Paulo Dinis
Chapter

Abstract

Botulinum toxin (BonTA) exerts its main therapeutic by inhibiting neuro-mediator exocytosis [1]. This was originally seen with acetylcholine hence the first diseases to be treated with BonTA injections where ocular strabismus and other striated muscular conditions [2]. In urologic diseases use of BonTA also started with application to striated muscle. In this case the urethral sphincter was targetd for treatment of sphincter-detrusor dissynergia in spinal cord injury patients [3]. With the rationale of smooth muscle relaxation, intra-vesical injections where approved initially for neurogenic detrusor over activity and later for the idiopathic overactive bladder syndrome. These applications showed great success and presently are mainstays of neurogenic and idiopathic bladder over activity treatment [4–6]. Since both the toxic effects as well as therapeutic effects of BonTA were seen as an efferent neuronal effect it was initially overlooked in the treatment of bladder pain.

References

  1. 1.
    Schiavo G, Rossetto O, Benfenati F, Poulain B, Montecucco C. Tetanus and botulinum neurotoxins are zinc proteases specific for components of the neuroexocytosis apparatus. Ann N Y Acad Sci. 1994;710:65–75.CrossRefPubMedGoogle Scholar
  2. 2.
    Scott AB. Botulinum toxin injection into extraocular muscles as an alternative to strabismus surgery. J Pediatr Ophthalmol Strabismus. 1980;17(1):21–5.PubMedGoogle Scholar
  3. 3.
    Dykstra DD, Sidi AA, Scott AB, Pagel JM, Goldish GD. Effects of botulinum A toxin on detrusor-sphincter dyssynergia in spinal cord injury patients. J Urol. 1988;139(5):919–22.CrossRefPubMedGoogle Scholar
  4. 4.
    Schurch B, Stohrer M, Kramer G, Schmid DM, Gaul G, Hauri D. Botulinum-A toxin for treating detrusor hyperreflexia in spinal cord injured patients: a new alternative to anticholinergic drugs? Preliminary results. J Urol. 2000;164(3 Pt 1):692–7.CrossRefPubMedGoogle Scholar
  5. 5.
    Sahai A, Khan MS, Dasgupta P. Efficacy of botulinum toxin-A for treating idiopathic detrusor overactivity: results from a single center, randomized, double-blind, placebo controlled trial. J Urol. 2007;177(6):2231–6.CrossRefPubMedGoogle Scholar
  6. 6.
    Flynn MK, Webster GD, Amundsen CL. The effect of botulinum-A toxin on patients with severe urge urinary incontinence. J Urol. 2004;172(6 Pt 1):2316–20.CrossRefPubMedGoogle Scholar
  7. 7.
    Welch MJ, Purkiss JR, Foster KA. Sensitivity of embryonic rat dorsal root ganglia neurons to Clostridium botulinum neurotoxins. Toxicon. 2000;38(2):245–58.CrossRefPubMedGoogle Scholar
  8. 8.
    Apostolidis A, Popat R, Yiangou Y, Cockayne D, Ford AP, Davis JB, et al. Decreased sensory receptors P2X3 and TRPV1 in suburothelial nerve fibers following intradetrusor injections of botulinum toxin for human detrusor overactivity. J Urol. 2005;174(3):977–82. discussion 82-3CrossRefPubMedGoogle Scholar
  9. 9.
    Smith CP, Radziszewski P, Borkowski A, Somogyi GT, Boone TB, Chancellor MB. Botulinum toxin a has antinociceptive effects in treating interstitial cystitis. Urology. 2004;64(5):871–5. discussion 5CrossRefPubMedGoogle Scholar
  10. 10.
    Giannantoni A, Costantini E, Di Stasi SM, Tascini MC, Bini V, Porena M. Botulinum A toxin intravesical injections in the treatment of painful bladder syndrome: a pilot study. Eur Urol. 2006;49(4):704–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Giannantoni A, Mearini E, Del Zingaro M, Proietti S, Porena M. Two-year efficacy and safety of botulinum a toxin intravesical injections in patients affected by refractory painful bladder syndrome. Curr Drug Deliv. 2010;7(1):1–4.CrossRefPubMedGoogle Scholar
  12. 12.
    Avelino A, Cruz C, Nagy I, Cruz F. Vanilloid receptor 1 expression in the rat urinary tract. Neuroscience. 2002;109(4):787–98.CrossRefPubMedGoogle Scholar
  13. 13.
    Pinto R, Lopes T, Frias B, Silva A, Silva JA, Silva CM, et al. Trigonal injection of botulinum toxin A in patients with refractory bladder pain syndrome/interstitial cystitis. Eur Urol. 2010;58(3):360–5.CrossRefPubMedGoogle Scholar
  14. 14.
    Kuo HC, Chancellor MB. Comparison of intravesical botulinum toxin type A injections plus hydrodistention with hydrodistention alone for the treatment of refractory interstitial cystitis/painful bladder syndrome. BJU Int. 2009;104(5):657–61.CrossRefPubMedGoogle Scholar
  15. 15.
    Kuo HC, Jiang YH, Tsai YC, Kuo YC. Intravesical botulinum toxin-A injections reduce bladder pain of interstitial cystitis/bladder pain syndrome refractory to conventional treatment - A prospective, multicenter, randomized, double-blind, placebo-controlled clinical trial. Neurourol Urodyn. 2016;35(5):609–14.CrossRefPubMedGoogle Scholar
  16. 16.
    Akiyama Y, Nomiya A, Niimi A, Yamada Y, Fujimura T, Nakagawa T, et al. Botulinum toxin type A injection for refractory interstitial cystitis: a randomized comparative study and predictors of treatment response. Int J Urol. 2015;22(9):835–41.CrossRefPubMedGoogle Scholar
  17. 17.
    Pinto R, Lopes T, Silva J, Silva C, Dinis P, Cruz F. Persistent therapeutic effect of repeated injections of onabotulinum toxin a in refractory bladder pain syndrome/interstitial cystitis. J Urol. 2013;189(2):548–53.CrossRefPubMedGoogle Scholar
  18. 18.
    Kasyan G, Pushkar D. 822 randomized controlled trial for efficacy of botulinum toxin type a in treatment of patients suffering bladder pain syndrome/interstitial cystitis with hunners’ lesions preliminary results. J Urol. 2012;187(4):e335–e6.CrossRefGoogle Scholar
  19. 19.
    Shim SR, Cho YJ, Shin IS, Kim JH. Efficacy and safety of botulinum toxin injection for interstitial cystitis/bladder pain syndrome: a systematic review and meta-analysis. Int Urol Nephrol. 2016;48(8):1215–27.CrossRefPubMedGoogle Scholar
  20. 20.
    Wang J, Wang Q, Wu Q, Chen Y, Wu P. Intravesical botulinum toxin A injections for bladder pain syndrome/interstitial cystitis: a systematic review and meta-analysis of controlled studies. Med Sci Monit. 2016;22:3257–67.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Kuo YC, Kuo HC. Adverse events of intravesical onabotulinumtoxinA injection between patients with overactive bladder and interstitial cystitis--different mechanisms of action of botox on bladder dysfunction? Toxins (Basel). 2016;8(3):75.CrossRefGoogle Scholar
  22. 22.
    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(6):1117–24.CrossRefPubMedGoogle Scholar
  23. 23.
    Ahmadi H, Montaser-Kouhsari L, Kajbafzadeh A-M. 744 intravesical electromotive botulinum toxin type A administration: preliminary findings for the treatment of children with myelomeningocele and refractory neurogenic detrusor overactivity. J Urol. 2010;183(4):e291.CrossRefGoogle Scholar
  24. 24.
    Stav K, Vinshtok Y, Jeshurun M, Ivgy-May N, Gerassi T, Zisman A. PD20-03 pilot study evaluating safety and feasibility of intravesical instillation of botulinum toxin in hydrogel-based slow release delivery system in PBS/IC patients. J Urol. 2015;193(4):e398.CrossRefGoogle Scholar
  25. 25.
    Tyagi P, Kashyap M, Yoshimura N, Chancellor M, Chermansky CJ. Past, present and future of chemodenervation with botulinum toxin in the treatment of overactive bladder. J Urol. 2017;197(4):982–90.CrossRefPubMedGoogle Scholar
  26. 26.
    Hanno PM, Erickson D, Moldwin R, Faraday MM, American Urological A. Diagnosis and treatment of interstitial cystitis/bladder pain syndrome: AUA guideline amendment. J Urol. 2015;193(5):1545–53.CrossRefPubMedGoogle Scholar
  27. 27.
    Engeler D, Baranowski AP, Borovicka J, Dinis-Oliveira P, Elneil S, Hughes J, et al. EAU guidelines on chronic pelvic pain. Arnhem: EAU Guidelines Office; 2016.Google Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of Urology, Faculty of MedicineHospital de São JoãoPortoPortugal

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