title: Intravesical glucidic capsaicin versus glucidic solvent in neurogenic detrusor overactivity: a double blind controlled randomized study.
abstract: OBJECTIVE
  Many studies report the use of alcoholic capsaicin instillation to treat neurogenic detrusor overactivity (NDO) in spinal cord injured (SCI) and multiple sclerosis (MS) patients. However, poor tolerability due to the irritative effect of the ethanol solvent limits its use. Our study aimed to evaluate the efficacy and tolerability of a new formulation of capsaicin in a glucidic solution in a multicenter clinical trial.
  
  
  METHODS
  Thirty-three patients (26MS/7SCI) suffering from urinary incontinence due to refractory NDO were prospectively enrolled in a double-blind placebo controlled study and randomized to capsaicin group (CG, N = 17) or solvent group (SG, N = 16). They respectively received an intravesical instillation of 100 ml capsaicin diluted in glucidic solvent (CG) or glucidic solvent alone (SG). Efficacy (voiding chart, maximum cystometric capacity (MCC)) and tolerability were evaluated on days 0 (D0), 30 and 90.
  
  
  RESULTS
  On D0, groups were homogeneous. On D30, significant improvement of overactive bladder syndrome and an increase in MCC were shown in CG, whereas there were no improvement in SG. No significant improvement was shown on D90 in both groups. There were no significant differences between groups regarding prevalence, duration, or intensity of side effects, except for short duration pubic pain during instillation more often reported in CG (58.8%) than in SG (12.5%) (P < 0.01).
  
  
  CONCLUSIONS
  This placebo controlled study using glucidic capsaicin confirms its short-term efficacy in NDO patients. Global tolerance of glucidic capsaicin appeared satisfactory. Long-term efficacy and tolerance of repeated glucidic capsaicin instillations need to be evaluated.
authors.affiliation: Physical Medicine and Neurorehabilitation Unit, Bordeaux University Hospital, Bordeaux, France. marianne.de-seze@chu-bordeaux.fr
authors.forename: Marianne
authors.initials: M
authors.lastname: de Sèze
authors.forename: Philippe
authors.initials: P
authors.lastname: Gallien
authors.forename: Pierre
authors.initials: P
authors.lastname: Denys
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Labat
authors.forename: Gérard
authors.initials: G
authors.lastname: Serment
authors.forename: Philippe
authors.initials: P
authors.lastname: Grise
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Salle
authors.forename: Sylvie
authors.initials: S
authors.lastname: Blazejewski
authors.forename: Cécile
authors.initials: C
authors.lastname: Hazane
authors.forename: Nicholas
authors.initials: N
authors.lastname: Moore
authors.forename: Pierre-Alain
authors.initials: PA
authors.lastname: Joseph
mesh_terms: D000328:Adult; D002211:Capsaicin / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007552:Isotonic Solutions / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000187:drug effects / Q000502:physiology; D009130:Muscle, Smooth / Q000187:drug effects / Q000503:physiopathology; D009844:Oligosaccharides / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D001750:Urinary Bladder, Neurogenic / Q000188:drug therapy*; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*; D014554:Urination / Q000502:physiology
chemical_list: D007552:Isotonic Solutions; D009844:Oligosaccharides; D002211:Capsaicin