Botulinum toxin - novel therapeutic option in the treatment of urinary tract dysfunction

Overactive bladder (OAB) has significant morbidity in the general population, and effective management is important both to minimize the impact on the patient's quality of life and to prevent the development of chronic health problems. Accumulating data from clinical studies and a growing body of clinical experience suggest that botulinum toxin may be an appropriate treatment, particularly in patients in whom the efficacy or tolerability of anticholinergics is in doubt. Injection of BTX appears to have a positive therapeutic effect in multiple conditions, including detrusor hyperreflexia and detrusor external sphincter dyssynergia, and nonneurogenic conditions such as pelvic floor spasticity, refractory overactive bladder and, possibly, benign prostatic hyperplasia. Interstitial cystitis may even be potentially cured with bladder BTX injection. This supplement supplies a rationale for the use of BoNTA in OAB, discussing its mechanism of action and presenting data on its efficacy and safety in patients with detrusor overactivity.