title: Current and potential urological applications of botulinum toxin A.
abstract: Botulinum toxin subtype A (BoNT-A) is a potent neurotoxin that can selectively modulate neurotransmitter release from nerve endings, resulting in muscular paralysis. BoNT-A might also act on sensory nerves, and have an anti-inflammatory effect. In the first urological use of BoNT-A, injection into the urethral sphincters of patients with detrusor-sphincter dyssynergia resulted in a reduction of urethral resistance and improved voiding efficiency. Subsequently, intravesical BoNT-A injections have received regulatory approval for treatment of neurogenic detrusor overactivity owing to spinal cord lesions or multiple sclerosis, and idiopathic overactive bladder in adults. BoNT-A has also been widely used to treat patients with the off-label indications of neurogenic or non-neurogenic voiding dysfunction and male lower urinary tract symptoms owing to BPH and bladder-neck dysfunction. Other indications for which urologists have applied BoNT-A injections include interstitial cystitis/bladder pain syndrome, bladder oversensitivity and chronic pelvic pain syndrome. BoNT-A is currently delivered as an intravesical injection; however, use of liposome encapsulated formulations is also beginning to show some therapeutic potential.
authors.affiliation: Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, 707, Section 3, Chung-Yang Road, Hualien, Taiwan.
authors.forename: Yuan-Hong
authors.initials: YH
authors.lastname: Jiang
authors.affiliation: Department of Urology, Cardinal Tien Hospital and Fu-Jen Catholic University, 362 Zhong Zheng Road, Xindian District, New Taipei City, Taiwan.
authors.forename: Chun-Hou
authors.initials: CH
authors.lastname: Liao
authors.affiliation: Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, 707, Section 3, Chung-Yang Road, Hualien, Taiwan.
authors.forename: Hann-Chorng
authors.initials: HC
authors.lastname: Kuo
mesh_terms: D065087:Acetylcholine Release Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D019274:Botulinum Toxins, Type A / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D009465:Neuromuscular Agents / Q000494:pharmacology / Q000627:therapeutic use*; D014570:Urologic Diseases / Q000188:drug therapy*
chemical_list: D065087:Acetylcholine Release Inhibitors; D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A; C545476:incobotulinumtoxinA