title: Intravesical botulinum toxin A injections in the treatment of painful bladder syndrome/interstitial cystitis: a systematic review.
abstract: OBJECTIVE
  Intravesical botulinum toxin A (BTX-A) is emerging as a potential new treatment for refractory interstitial cystitis (IC). However, there has been conflicting evidence on this treatment's effectiveness. The aim of our systematic review was to assess the effectiveness and adverse effects of intravesical BTX-A in IC.
  
  
  METHODS
  Randomised controlled trials (RCTs) and prospective studies of relevance were identified, assessed for inclusion and then analysed by two independent reviewers.
  
  
  RESULTS
  Ten (three RCTs and seven prospective cohort) studies with a total of 260 participants were included. Eight studies reported improvement in symptoms. Urodynamic parameters were variable. Meta-analysis was not performed due to heterogeneity in reporting of outcomes. Some adverse events, e.g. dysuria and voiding difficulty, were noted (19 out of 260 were required to self-catheterize at anytime postoperatively).
  
  
  CONCLUSIONS
  The evidence from the studies thus far suggests a trend towards short-term benefit with intravesical BTX-A injections in refractory IC, but further robust evidence should be awaited.
authors.affiliation: Birmingham Women's NHS Foundation Trust, Metchley Park Road, Edgbaston, Birmingham, UK. drsahithi@rediffmail.com
authors.forename: Sahithi
authors.initials: S
authors.lastname: Tirumuru
authors.forename: Deyaa
authors.initials: D
authors.lastname: Al-Kurdi
authors.forename: Pallavi
authors.initials: P
authors.lastname: Latthe
mesh_terms: D000283:Administration, Intravesical; D019274:Botulinum Toxins, Type A / Q000009:adverse effects / Q000627:therapeutic use*; D018856:Cystitis, Interstitial / Q000188:drug therapy*; D006801:Humans; D009465:Neuromuscular Agents / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A
references.citation: Urology. 2000 Dec 20;56(6):940-5
references.pmid: 11113737
references.citation: Control Clin Trials. 1996 Feb;17(1):1-12
references.pmid: 8721797
references.citation: Surgeon. 2007 Dec;5(6):331-3
references.pmid: 18080606
references.citation: Urology. 2007 Sep;70(3):463-8
references.pmid: 17905097
references.citation: BJU Int. 2008 Sep;102(6):704-6
references.pmid: 18485037
references.citation: Neurourol Urodyn. 2009;28(4):274-86
references.pmid: 19260081
references.citation: J Urol. 2007 Apr;177(4):1390-4
references.pmid: 17382739
references.citation: Urol Clin North Am. 2005 Feb;32(1):89-99
references.pmid: 15698881
references.citation: Eur Urol. 2008 Jan;53(1):60-7
references.pmid: 17900797
references.citation: Urol Int. 2005;75(2):170-4
references.pmid: 16123573
references.citation: J Urol. 1988 Jul;140(1):203-6
references.pmid: 3379688
references.citation: Neurourol Urodyn. 2010;29(1):191-8
references.pmid: 20025029
references.citation: BJU Int. 2009 Sep;104(5):657-61
references.pmid: 19338543
references.citation: J Urol. 2008 Mar;179(3):1031-4
references.pmid: 18206941
references.citation: Urology. 2004 Nov;64(5):871-5; discussion 875
references.pmid: 15533466