The clinical application of intravesical botulinum toxin A injection in patients with overactive bladder and interstitial cystitis

Botulinum toxin A (BoNT-A) has been widely used in several urological functional disorders including neurogenic detrusor overactivity (NDO), overactive bladder (OAB), lower urinary tract dysfunction, and interstitial cystitis/bladder pain syndrome (IC/BPS). Chronic inflammation is found in a large p...

Full description

Saved in:
Bibliographic Details
Main Authors: Yuan-Hong Jiang, Jia-Fong Jhang, Hann-Chorng Kuo
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-01-01
Series:Tzu Chi Medical Journal
Subjects:
Online Access:http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2023;volume=35;issue=1;spage=31;epage=37;aulast=Jiang
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849396125142876160
author Yuan-Hong Jiang
Jia-Fong Jhang
Hann-Chorng Kuo
author_facet Yuan-Hong Jiang
Jia-Fong Jhang
Hann-Chorng Kuo
author_sort Yuan-Hong Jiang
collection DOAJ
description Botulinum toxin A (BoNT-A) has been widely used in several urological functional disorders including neurogenic detrusor overactivity (NDO), overactive bladder (OAB), lower urinary tract dysfunction, and interstitial cystitis/bladder pain syndrome (IC/BPS). Chronic inflammation is found in a large proportion of patients with OAB and IC/BPS. The chronic inflammation activates sensory afferents which resulting in central sensitization and bladder storage symptoms. Because BoNT-A can inhibit the sensory peptides released from the vesicles in sensory nerve terminals, the inflammation can be reduced and symptom subsided. Previous studies have demonstrated that the quality of life improved after BoNT-A injections, both in neurogenic and non-NDO. Although the use of BoNT-A in treatment of IC/BPS has not been approved by FDA, intravesical BoNT-A injection has been included in the AUA guideline as the fourth line therapy. Generally, intravesical injections of BoNT-A are well tolerated, though transient hematuria and urinary tract infection can occur after the procedure. In order to prevent these adverse events, experimental trials have been conducted to test if BoNT-A can be delivered into the bladder wall without intravesical injection under anesthesia such as using liposomes encapsulated BoNT-A or application of low energy shock wave on the bladder to facilitate BoNT-A penetrating across the urothelium and treat OAB or IC/BPS. This article reviews current clinical and basic researches of BoNT-A on OAB and IC/BPS.
format Article
id doaj-art-b1c35ab2d0e340ef80845ad210c31adf
institution Kabale University
issn 1016-3190
2223-8956
language English
publishDate 2023-01-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Tzu Chi Medical Journal
spelling doaj-art-b1c35ab2d0e340ef80845ad210c31adf2025-08-20T03:39:26ZengWolters Kluwer Medknow PublicationsTzu Chi Medical Journal1016-31902223-89562023-01-01351313710.4103/tcmj.tcmj_313_21The clinical application of intravesical botulinum toxin A injection in patients with overactive bladder and interstitial cystitisYuan-Hong JiangJia-Fong JhangHann-Chorng KuoBotulinum toxin A (BoNT-A) has been widely used in several urological functional disorders including neurogenic detrusor overactivity (NDO), overactive bladder (OAB), lower urinary tract dysfunction, and interstitial cystitis/bladder pain syndrome (IC/BPS). Chronic inflammation is found in a large proportion of patients with OAB and IC/BPS. The chronic inflammation activates sensory afferents which resulting in central sensitization and bladder storage symptoms. Because BoNT-A can inhibit the sensory peptides released from the vesicles in sensory nerve terminals, the inflammation can be reduced and symptom subsided. Previous studies have demonstrated that the quality of life improved after BoNT-A injections, both in neurogenic and non-NDO. Although the use of BoNT-A in treatment of IC/BPS has not been approved by FDA, intravesical BoNT-A injection has been included in the AUA guideline as the fourth line therapy. Generally, intravesical injections of BoNT-A are well tolerated, though transient hematuria and urinary tract infection can occur after the procedure. In order to prevent these adverse events, experimental trials have been conducted to test if BoNT-A can be delivered into the bladder wall without intravesical injection under anesthesia such as using liposomes encapsulated BoNT-A or application of low energy shock wave on the bladder to facilitate BoNT-A penetrating across the urothelium and treat OAB or IC/BPS. This article reviews current clinical and basic researches of BoNT-A on OAB and IC/BPS.http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2023;volume=35;issue=1;spage=31;epage=37;aulast=Jiangbotulinum toxininterstitial cystitisoveractive bladder
spellingShingle Yuan-Hong Jiang
Jia-Fong Jhang
Hann-Chorng Kuo
The clinical application of intravesical botulinum toxin A injection in patients with overactive bladder and interstitial cystitis
Tzu Chi Medical Journal
botulinum toxin
interstitial cystitis
overactive bladder
title The clinical application of intravesical botulinum toxin A injection in patients with overactive bladder and interstitial cystitis
title_full The clinical application of intravesical botulinum toxin A injection in patients with overactive bladder and interstitial cystitis
title_fullStr The clinical application of intravesical botulinum toxin A injection in patients with overactive bladder and interstitial cystitis
title_full_unstemmed The clinical application of intravesical botulinum toxin A injection in patients with overactive bladder and interstitial cystitis
title_short The clinical application of intravesical botulinum toxin A injection in patients with overactive bladder and interstitial cystitis
title_sort clinical application of intravesical botulinum toxin a injection in patients with overactive bladder and interstitial cystitis
topic botulinum toxin
interstitial cystitis
overactive bladder
url http://www.tcmjmed.com/article.asp?issn=1016-3190;year=2023;volume=35;issue=1;spage=31;epage=37;aulast=Jiang
work_keys_str_mv AT yuanhongjiang theclinicalapplicationofintravesicalbotulinumtoxinainjectioninpatientswithoveractivebladderandinterstitialcystitis
AT jiafongjhang theclinicalapplicationofintravesicalbotulinumtoxinainjectioninpatientswithoveractivebladderandinterstitialcystitis
AT hannchorngkuo theclinicalapplicationofintravesicalbotulinumtoxinainjectioninpatientswithoveractivebladderandinterstitialcystitis
AT yuanhongjiang clinicalapplicationofintravesicalbotulinumtoxinainjectioninpatientswithoveractivebladderandinterstitialcystitis
AT jiafongjhang clinicalapplicationofintravesicalbotulinumtoxinainjectioninpatientswithoveractivebladderandinterstitialcystitis
AT hannchorngkuo clinicalapplicationofintravesicalbotulinumtoxinainjectioninpatientswithoveractivebladderandinterstitialcystitis