Botulinum toxin and refractory non-neurogenic overactive detrusor.
OBJECTIVE
To study the value and efficacy of botulinum toxin for treatment of cases of non-neurogenic detrusor overactivity (NNDO) that are refractory to anticholinergic drugs.


METHODS
A systematic review of the literature, based on a keyword search of the Medline database. Selection of articles in French and English (meta-analyses, reviews, case studies and randomized, controlled clinical trials) on intradetrusor botulinum toxin injection in the management of refractory NNDO.


RESULTS
Nineteen publications (including three randomized, controlled trials) were selected. Intradetrusor injection of botulinum toxin in patients with refractory NNDO has produced promising results, with a significant improvement in physical symptoms, urodynamic parameters and quality of life. The rare side effects consist primarily of dose-dependent urine retention.


CONCLUSIONS
On the basis of preliminary data, botulinum toxin appears to be a valuable therapeutic option and fills the gap between anticholinergics and surgery in the treatment of NNDO that is refractory to anticholinergic agents. Botulinum toxin has a promising future in urology but requires further scientific evaluation.
Ksibi
I
I
institut national d'orthopédie Mohamed Kassab, La Manouba, Tunisia. imeneksibi@yahoo.fr
Godard
A-L
AL
Azouvi
P
P
Denys
P
P
Dziri
C
C
D001905:Botulinum Toxins / Q000627:therapeutic use*; D006801:Humans; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D011788:Quality of Life; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*; D014563:Urodynamics
D009465:Neuromuscular Agents; D001905:Botulinum Toxins