Intravesical botulinum toxin A injections in the treatment of painful bladder syndrome/interstitial cystitis: a systematic review.
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.
Tirumuru
Sahithi
S
Birmingham Women's NHS Foundation Trust, Metchley Park Road, Edgbaston, Birmingham, UK. drsahithi@rediffmail.com
Al-Kurdi
Deyaa
D
Latthe
Pallavi
P
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*
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A
Urology. 2000 Dec 20;56(6):940-5
11113737
Control Clin Trials. 1996 Feb;17(1):1-12
8721797
Surgeon. 2007 Dec;5(6):331-3
18080606
Urology. 2007 Sep;70(3):463-8
17905097
BJU Int. 2008 Sep;102(6):704-6
18485037
Neurourol Urodyn. 2009;28(4):274-86
19260081
J Urol. 2007 Apr;177(4):1390-4
17382739
Urol Clin North Am. 2005 Feb;32(1):89-99
15698881
Eur Urol. 2008 Jan;53(1):60-7
17900797
Urol Int. 2005;75(2):170-4
16123573
J Urol. 1988 Jul;140(1):203-6
3379688
Neurourol Urodyn. 2010;29(1):191-8
20025029
BJU Int. 2009 Sep;104(5):657-61
19338543
J Urol. 2008 Mar;179(3):1031-4
18206941
Urology. 2004 Nov;64(5):871-5; discussion 875
15533466