Abstract
Botulinum toxin (BTX), a neurotoxin produced by the gram-positive, rod-shaped anaerobic bacterium Clostridium botulinum, was isolated in 1897 by Belgian scientist Professor Pierre Emile van Ermengem. BTX acts by blocking the release of acetylcholine at the neuromuscular junction. As a result of this chemodenervation, a temporary flaccid paralysis ensues. Different medical disciplines have taken advantage of this temporary paralysis to treat muscular hypercontraction. BTX was first approved by the US Food and Drug Administration in 1989 for use in patients with strabismus and blepharospasm. Since then, BTX has been used to treat a number of different neuromuscular disorders. Although not approved by the US Food and Drug Administration, BTX has been used successfully in urology to treat neurogenic and non-neurogenic detrusor overactivity, detrusor-sphincter dyssynergia, motor and sensory urge, and chronic pain syndromes.
Similar content being viewed by others
References and Recommended Reading
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. Comprehensive literature review on the use of Botox in voiding disorders.
Sahai A, Khan M, Fowler CJ, et al.: Botulinum toxin for the treatment of lower urinary tract symptoms: a review. Neurourol Urodyn 2005, 24:2 -12. Detailed review of the literature on the application of Botox in the urinary tract.
Frenkl TL, Rackley RR: Injectable neuromodulatory agents: botulinum toxin therapy. Urol Clin North Am 2005, 32:89 -99. Comprehensive review of the use of Botox in urology. It includes pharmacology, indications, and injection techniques.
Schurch B, Stohrer M, Kramer G, et al.: Botulinum-A toxin for treating detrusor hyperreflexia in spinal cord injured patients: a new alternative to anticholinergic drugs? Preliminary results. J Urol 2000, 164:692 -697.
Reitz A, Stohrer M, Kramer G, et al.: European experience of 200 cases treated with botulinum-A toxin injections into the detrusor muscle for urinary incontinence due to neurogenic detrusor overactivity. Eur Urol 2004, 45:510 -515.
Grosse J, Kramer G, Stohrer M: Success of repeat detrusor injections of botulinum a toxin in patients with severe neurogenic detrusor overactivity and incontinence. Eur Urol 2005, 47:653 -659.
Dykstra D, Enriquez A, Valley M: Treatment of overactive bladder with botulinum toxin type B: a pilot study. Int Urogynecol J Pelvic Floor Dysfunct 2003, 14:424 -426.
Rapp DE, Lucioni A, Katz EE, et al.: Use of botulinum-A toxin for the treatment of refractory overactive bladder symptoms: an initial experience. Urology 2004, 63:1071 -1075.
Schulte-Baukloh H, Weiss C, Stolze T, et al.: Botulinum-A toxin for treatment of overactive bladder without detrusor overactivity: urodynamic outcome and patient satisfaction. Urology 2005, 66:82 -87.
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.
Schurch B, Hauri D, Rodic B, et al.: Botulinum-A toxin as a treatment of detrusor-sphincter dyssynergia: a prospective study in 24 spinal cord injury patients. J Urol 1996, 155:1023 -1029.
de Seze M, Petit H, Gallien P, et al.: Botulinum A toxin and detrusor sphincter dyssynergia: a double-blind, lidocainecontrolled study in 13 patients with spinal cord disease. Eur Urol 2002, 42:56 -62.
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.
Kuo HC: Botulinum A toxin urethral injection for the treatment of lower urinary tract dysfunction. J Urol 2003, 170:1908 -1912.
Chuang YC, Yoshimura N, Huang CC, et al.: Intravesical botulinum toxin A administration produces analgesia against acetic acid-induced bladder pain responses in rats. J Urol 2004, 172:1529 -1532.
Zermann D, Ishigooka M, Schubert J, et al.: Perisphincteric injection of botulinum toxin type A: a treatment option for patients with chronic prostatic pain? Eur Urol 2000, 38:393 -399.
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.
Smith CP, Radziszewski P, Borkowski A, et al.: Botulinum toxin a has antinociceptive effects in treating interstitial cystitis. Urology 2004, 64:871 -875.
Grousse A, Gurunadha HS, Tunuguntla R, et al.: Dose-finding, prospective, randomized study to evaluate the efficacy and safety of botulinum-A toxin for refractory non-neurogenic overactive bladder. J Urol 2005, 173:305.
Schurch B, de Seze M, Denys P, et al.: Botulinum toxin type A is a safe and effective treatment for neurogenic urinary incontinence: results of a single-treatment, randomized, placebo-controlled 6-month study. J Urol 2005, 174:196 -200. Double-blind, placebo-controlled study examining the effect of two different doses of BTX-A (200 and 300 units) in patients with neurogenic DO.
Kuo HC: Clinical effects of suburothelial injection of botulinum A toxin on patients with non-neurogenic detrusor overactivity refractory to anticholinergics. Urology 2005, 66:94 -98.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Moore, C., Rackley, R. & Goldman, H. Urologic applications of botox. Curr Urol Rep 6, 419–423 (2005). https://doi.org/10.1007/s11934-005-0035-0
Issue Date:
DOI: https://doi.org/10.1007/s11934-005-0035-0