title: Intravesical resiniferatoxin for the treatment of storage lower urinary tract symptoms in patients with either interstitial cystitis or detrusor overactivity: a meta-analysis.
abstract: BACKGROUND
  While Resin-iferatoxin (RTX) has been widely used for patients with storage lower urinary tract symptoms (LUTS), its clinical efficiency hasn't yet been well evaluated. A meta-analysis was performed to evaluate the exact roles of intravesical RTX for the treatment of storage LUTS in patients with either interstitial cystitis (IC) or detrusor overactivity (DO).
  
  
  METHODS
  A meta-analysis of RTX treatment was performed through a comprehensive search of the literature. In total, 2,332 records were initially recruited, 1,907 from Elsevier, 207 from Medline and 218 from the Web of Science. No records were retrieved from the Embase or Cochrane Library. Seven trials with 355 patients were included and one trial was excluded because of the lack of extractable data. The analyses were all performed using RevMan 5.1 and MIX 2.0.
  
  
  RESULTS
  Bladder pain was significantly reduced after RTX therapy in patients with either IC or DO. The average decrease of the visual an alogue pain scale was 0.42 after RTX treatment (p = 0.02). The maximum cystometric capacity (MCC) was significantly increased in patients with DO (MCC increase, 53.36 ml, p = 0.006) but not in those with IC (MCC increase, -19.1 ml, p = 0.35). No significant improvement in urinary frequency, nocturia, incontinence or the first involuntary detrusor contraction (FDC) was noted after RTX therapy (p = 0.06, p = 0.52, p = 0.19 and p = 0.41, respectively).
  
  
  CONCLUSIONS
  RTX could significantly reduce bladder pain in patients with either IC or DO, and increase MCC in patients with DO; however, no significant improvement was observed in frequency, nocturia, incontinence or FDC. Given the limitations in the small patient size and risk of bias in the included trials, great caution should be taken when intravesical RTX is used before a large, multicenter, well-designed random control trial with a long-term follow-up is carried out to further assess the clinical efficacy of RTX in in patients with storage LUTS.
authors.affiliation: Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Changcheng
authors.initials: C
authors.lastname: Guo
authors.affiliation: Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Bin
authors.initials: B
authors.lastname: Yang
authors.affiliation: Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Wenyu
authors.initials: W
authors.lastname: Gu
authors.affiliation: Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Bo
authors.initials: B
authors.lastname: Peng
authors.affiliation: Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Shengqiang
authors.initials: S
authors.lastname: Xia
authors.affiliation: Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Fengqiang
authors.initials: F
authors.lastname: Yang
authors.affiliation: Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Deyi
authors.initials: D
authors.lastname: Wen
authors.affiliation: Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Geng
authors.affiliation: Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Junhua
authors.initials: J
authors.lastname: Zheng
mesh_terms: D000283:Administration, Intravesical; D000328:Adult; D018856:Cystitis, Interstitial / Q000188:drug therapy* / Q000503:physiopathology; D004224:Diterpenes / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D053158:Nocturia / Q000188:drug therapy / Q000503:physiopathology; D010147:Pain Measurement; D017594:Publication Bias; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000188:drug therapy* / Q000503:physiopathology; D014549:Urinary Incontinence / Q000188:drug therapy / Q000503:physiopathology; D014554:Urination; D014563:Urodynamics / Q000187:drug effects
chemical_list: D004224:Diterpenes; C024353:resiniferatoxin