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Urologic applications of botulinum toxin therapy for voiding dysfunction

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Abstract

Botulinum toxin is primarily a presynaptic neuromuscular blocking agent inducing selective and reversible muscle weakness up to several months when injected intramuscularly in small quantities. The clinical use of botulinum toxin type-A has gained widespread acceptance and application for numerous adult and pediatric spasticity syndromes. This has led to the urologic adoption of this minimally invasive therapy for the treatment of idiopathic and neurogenic detrusor overactivity, interstitial cystitis, detrusor-sphincter dyssynergia, urinary retention, and prostatic conditions. Outlined below is an overview of the clinical adoption of this therapy for the treatment of various dysfunctions of the lower urinary tract.

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References and Recommended Reading

  1. Centers for Disease Control and Prevention: Botulism in the United States, 1899–1996: Handbook for Epidemiologists, Clinicians, and Laboratory Workers. Atlanta: Centers for Disease Control and Prevention; 1998.

    Google Scholar 

  2. Gill MD: Bacterial toxins: a table of lethal amounts. Microbiol Rev 1982, 46:86–94.

    PubMed  CAS  Google Scholar 

  3. Foran PG, Mohammed N, Lisk GO, et al.: Evaluation of the therapeutic usefulness of botulinum neurotoxin B, C1, E, and F compared with the long-lasting type A. J Biol Chem 2003, 278:1363–1371.

    Article  PubMed  CAS  Google Scholar 

  4. Aoki KR, Guyer B: Botulinum toxin type A and other botulinum toxin serotypes: a comparative review of biochemical and pharmacological actions. Eur J Neurol 2001, 8(suppl 5):21–29.

    Article  PubMed  Google Scholar 

  5. de Paiva A, Meunier FA, Molgo J, et al.: Functional repair of motor endplates after botulinum neurotoxin type A poisoning: biphasic switch of synaptic activity between nerve sprouts and their parent terminals. Proc Natl Acad Sci U S A 1999, 96:3200–3205.

    Article  Google Scholar 

  6. Filippi GM, Errico P, Santarelli R, et al.: Botulinum A toxin effects on rat jaw muscle spindles. Acta Otolaryngol 1993, 113:400–404.

    PubMed  CAS  Google Scholar 

  7. Rosales RL, Arimura K, Takenaga S, Osame M: Extrafusal and intrafusal muscle effects in experimental botulinum toxin A injection. Muscle Nerve 1996, 19:488–496.

    Article  PubMed  CAS  Google Scholar 

  8. Moreno-Lopez B: Discharge properties of extraocular muscle motoneurons in the alert cat following the peripheral injection of botulinum neurotoxin type A. Mov Disord 1995, 10:386.

    Google Scholar 

  9. Priori A, Berardelli A, Mercuri B, Manfredi M: Physiological effects produced by botulinum toxin treatment of upper limb dystonia: changes in reciprocal inhibition between forearm muscles. Brain 1995, 118:801–807.

    Article  PubMed  Google Scholar 

  10. Aoki R: Comparison of the therapeutic windows of different botulinum neurotoxin preparations in an animal model. Neurology 2003, 60(suppl 1):A212-A213.

    Google Scholar 

  11. Botox Package Insert. Irvine, CA: Allergan, Inc.

  12. Leippold T, Reitz A, Schurch B: Botulinum toxin as a new therapy option for voiding disorders: current state of the art. Eur Urol 2003, 44:165–174. Excellent clinical review of the urologic applications of botulinum toxin therapies.

    Article  PubMed  CAS  Google Scholar 

  13. Smith CP, Chancellor MB: Emerging role of botulinum toxin in the management of voiding dysfunction. J Urol 2004, 2128–2137. The authors provide a basic science and clinical review of the urologic applications of botulinum toxin therapies.

  14. Del Popolo G, Li MV, Panariello G, et al.: English botulinum toxin A in the treatment of neurogenic detrusor overactivity. Neurourol Urodyn 2003, 22:498–499.

    Google Scholar 

  15. Wyndaele JJ, Van Dromme SA: Muscular weakness as side effect of botulinum toxin injection for neurogenic detrusor overactivity. Spinal Cord 2002, 40:599–600.

    Article  PubMed  CAS  Google Scholar 

  16. Dykstra DD, Sidi AA: Treatment of detrusor-sphincter dyssynergia with botulinum A toxin: a double-blind study. Arch Phys Med Rehabil 1990, 71:24–26. A double-blind, placebo-controlled trial with crossover limited to five patients with a 4-week follow-up.

    PubMed  CAS  Google Scholar 

  17. BOTOX (Botulinum toxin type A, purified neurotoxin complex) product information. http//www.botox.com/ prescribing_info.html, 2000.

  18. Data on file: A Randomized, Multicenter, Double-blind, Placebocontrolled Study of Intramuscular BOTOX) Botulinum Toxin Type A) Purified Neurotoxin Complex (original 79–11 BOTOX) for the Treatment of Cervical Dystonia. Irvine, CA: Allergan, Inc.; 1998.

  19. Jankovic J, Vuong KD, Ahsan J: Comparison of efficacy and immunogenicity of original versus current botulinum toxin in cervical dystonia. Neurology 2003, 60:1186–1188.

    PubMed  CAS  Google Scholar 

  20. Stohrer M, Schurch B, Kramer G, et al.: Botulinum toxin A in the treatment of detrusor hyper-reflexia in spinal cord injured patients: A new alternative to medical and surgical procedures? Neurourol Urodyn 1999, 18:401.

    Article  Google Scholar 

  21. Schurch B, Stohrer M, Kramer G, et al.: Botulinum A toxin for treating detrusor hyper-reflexia in spinal cord injured patients: a new alternative to anticholinergic drugs? Preliminary results. J Urol 2000, 164:692–697.

    Article  PubMed  CAS  Google Scholar 

  22. Taqi D, Gunyea I, Bhakta B, et al.: Botulinum toxin type A (Botox) in the treatment of refractory myofascial cervicothoracic pain: a prospective trial. Pain Med 2002, 3:173–174.

    Google Scholar 

  23. Smuts JA, Barnard PW: Botulinum toxin type A in the treatment of headache syndromes: a clinical report of 79 patients. Cephalgia 2000, 20:332.

    Article  Google Scholar 

  24. Aoki KR: Evidence for antinociceptive activity of botulinum toxin type A in pain management. Headache 2003, 43(suppl 1):S9-S15.

    Article  PubMed  Google Scholar 

  25. Klein AW: The therapeutic potential of botulinum toxin. Dermatol Surg 2004, 30:452–455.

    Article  PubMed  Google Scholar 

  26. Welch M, Purkiss J, Foster K: Sensitivity of embryonic rat dorsal root ganglia neurons to Clostridium botulinum neurotoxins. Toxicon 2000, 38:245–258.

    Article  PubMed  CAS  Google Scholar 

  27. Cui M, Khanijou S, Rubino J, Aoki KR: Subcutaneous administration of botulinum toxin A reduces formalin-induced pain. Pain 2004, 107:125–133.

    Article  PubMed  CAS  Google Scholar 

  28. Zermann D, Ishigooka M, Schubert J, Schmidt RA: Perisphincteric injection of botulinum toxin type A: a treatment option for patients with chronic pelvic pain? Eur Urol 2000, 38:393–399.

    Article  PubMed  CAS  Google Scholar 

  29. Jarvis SK, Abbott JA, Lenart MB, et al.: Pilot study of botulinum toxin type A in the treatment of chronic pelvic pain associated with spasm of the levator ani muscles. Aust N Z J Obstet Gynaecol 2004, 44:46–50.

    Article  PubMed  Google Scholar 

  30. Phelan MW, Franks M, Somogyi GT, et al.: Botulinum toxin urethral sphincter injection to restore bladder emptying in men and women with voiding dysfunction. J Urol 2001, 165:1107–1110.

    Article  PubMed  CAS  Google Scholar 

  31. Kuo HC: Effect of botulinum A toxin in the treatment of voiding dysfunction due to detrusor underactivity. Urology 2003, 61:550–554.

    Article  PubMed  Google Scholar 

  32. de Seze M, Petit H, Gallien P, et al.: Botulinum A toxin and detrusor sphincter dyssynergia: a double-blind, lidocainecontrolled study of 13 patients with spinal cord disease. Eur Urol 2002, 42:56–62. A double-blind, lidocaine-controlled study evaluating the efficacy of Botox versus lidocaine in 13 patients with detrusor sphincter dyssynergia secondary to spinal cord disease. One transperineal injection of Botox into the external urethral sphincter was found to be superior to lidocaine injection as evidenced by decreased postvoid residual and maximal urethral pressure and increased patient satisfaction scores.

    Article  Google Scholar 

  33. Dykstra DD, Sidi AA, Scott AB, et al.: Effects of botulinum-A toxin on detrusor-sphincter dyssynergia in spinal cord injury patients. J Urol 1988, 139:919–922.

    PubMed  CAS  Google Scholar 

  34. Doggweiler R, Zermann D, Ishigooka M, et al.: Botox-induced prostatic involution. Prostate 1998, 37:44–50.

    Article  PubMed  CAS  Google Scholar 

  35. Maria G, Brisinda G, Civello IM, et al.: Relief by botulinum toxin of voiding dysfunction due to benign prostatic hyperplasia: results of a randomized, placebo-controlled study. Urology 2003, 62:259–265.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Section of Voiding Dysfunction and Female Urology, Glickman Urological Institute, Cleveland Clinic Foundation, A100, 9500 Euclid Avenue, 44195, Cleveland, OH, USA

    Raymond Rackley MD & Joseph Abdelmalak MD

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  1. Raymond Rackley MD
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  2. Joseph Abdelmalak MD
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Rackley, R., Abdelmalak, J. Urologic applications of botulinum toxin therapy for voiding dysfunction. Curr Urol Rep 5, 381–388 (2004). https://doi.org/10.1007/s11934-004-0088-5

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  • DOI: https://doi.org/10.1007/s11934-004-0088-5

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