Botulinum A toxin in the treatment of neurogenic detrusor overactivity: a consolidated field of application.
Several studies show promising results in terms of both clinical and urodynamic improvements, supporting the efficacy, safety and tolerability of botulinum toxin serotype A (BoNT-A) for managing neurogenic detrusor overactivity (DO). DO due to spinal cord injuries represents the most frequently treated dysfunction, where the efficacy appears to be high, with beneficial effects on quality of life. Data on the management of DO in patients with multiple sclerosis, cerebrovascular accidents and Parkinson's disease are scarce or absent; thus, the suitability of BoNT-A in the treatment neurogenic DO of other diseases of central nervous origin requires further investigation. Indeed, good quality, randomized controlled trials are still needed to identify not only the most appropriate patients to treat, but also the appropriate dose, administration technique, frequency of treatment and any eventual long-term complications. Thus, the use of intravesical BoNT-A in the control of neurogenic DO appears to be promising, but the drug is still in phase 3 clinical development, and further high-quality research is essential.
Giannantoni
Antonella
A
Department of Urology, University of Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy. agianton@tin.it
Mearini
Ettore
E
Del Zingaro
Michele
M
Santaniello
Francesco
F
Porena
Massimo
M
D000283:Administration, Intravesical; D000328:Adult; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002561:Cerebrovascular Disorders / Q000150:complications / Q000188:drug therapy; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000150:complications / Q000188:drug therapy; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000150:complications / Q000188:drug therapy*; D053201:Urinary Bladder, Overactive / Q000150:complications / Q000188:drug therapy*; D014549:Urinary Incontinence / Q000150:complications / Q000188:drug therapy*
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A