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Toxins 2018, 10(7), 260; https://doi.org/10.3390/toxins10070260

Novel Applications of OnabotulinumtoxinA in Lower Urinary Tract Dysfunction

Department of Urology, Buddhist Tzu Chi General Hospital, and Tzu Chi University, Hualien 970, Taiwan
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Received: 25 April 2018 / Revised: 20 June 2018 / Accepted: 22 June 2018 / Published: 26 June 2018
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Abstract

OnabotulinumtoxinA (BoNT-A) was first used to treat neurogenic lower urinary tract dysfunction (LUTD) 30 years ago. Recently, application of BoNT-A in LUTD have become more common since the approval of intravesical BoNT-A injection for patients with both overactive bladders (OAB) and neurogenic detrusor overactivity (NDO) by regulatory agencies in many countries. Although unlicensed, BoNT-A has been recommended to treat patients with interstitial cystitis/bladder pain syndrome (IC/BPS) under different guidelines. BoNT-A delivery with liposome-encapsulation and gelation hydrogel intravesical instillation provided a potentially less invasive and more convenient form of application for patients with OAB or IC/BPS. BoNT-A injections into the urethral sphincter for spinal cord injury patients with detrusor-sphincter dyssynergia have been used for a long time. New evidence revealed that it could also be applied to patients with non-neurogenic dysfunctional voiding. Previous studies and meta-analyses suggest that BoNT-A injections for patients with benign prostate hyperplasia do not have a better therapeutic effect than placebo. However, new randomized and placebo-controlled trials revealed intraprostatic BoNT-A injection is superior to placebo in specific patients. A recent trial also showed intraprostatic BoNT-A injection could significantly reduce pain in patients with chronic prostatitis. Both careful selection of patients and prudent use of urodynamic evaluation results to confirm diagnoses are essential for successful outcomes of BoNT-A treatment for LUTD. View Full-Text
Keywords: botulinum toxin; clinical trial; human; urodynamics botulinum toxin; clinical trial; human; urodynamics
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Jhang, J.-F.; Kuo, H.-C. Novel Applications of OnabotulinumtoxinA in Lower Urinary Tract Dysfunction. Toxins 2018, 10, 260.

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