Botulinum toxin for conditions of the female pelvis.
OBJECTIVE
Botulinum toxin has recently been approved by the Food and Drug Administration (FDA) for the treatment of urinary incontinence associated with neurogenic detrusor overactivity. However, it has also been used off-label for a multitude of other conditions in the female pelvis, including urological, gynecological, and colorectal. This article reviews the most recent data regarding its efficacy and safety, and administration techniques for those conditions.


METHODS
A literature review of the most relevant reports published between 1985 and 2012.


RESULTS
Urinary incontinence related to neurogenic detrusor overactivity is currently the only approved indication in the female pelvis. Other supported off-label uses include: idiopathic detrusor overactivity, interstitial cystitis/bladder pain syndrome, detrusor sphincter dyssynergia, high-tone pelvic floor dysfunction, anal fissure, anismus, and functional anal pain.


CONCLUSIONS
Botulinum toxin may effectively and safely be used in many conditions of the female pelvis. More high quality research is needed to better clarify its role in the therapeutic algorithm for those indications.
Division of Female Pelvic Medicine and Reconstructive Surgery, Drexel University College of Medicine, Philadelphia, PA, USA. dominique.el-khawand@drexelmed.edu
Dominique
D
El-Khawand
Salim
S
Wehbe
Kristene
K
Whitmore
D018726:Anti-Dyskinesia Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001004:Anus Diseases / Q000188:drug therapy*; D001905:Botulinum Toxins / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D059952:Pelvic Floor Disorders / Q000188:drug therapy*; D001745:Urinary Bladder Diseases / Q000188:drug therapy*
D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins