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Toxins 2015, 7(6), 2232-2250;

Novel Treatment of Chronic Bladder Pain Syndrome and Other Pelvic Pain Disorders by OnabotulinumtoxinA Injection

Department of Urology, Buddhist Tzu Chi General Hospital, and Tzu Chi University, Hualien 970, Taiwan
Author to whom correspondence should be addressed.
Academic Editor: Bahman Jabbari
Received: 3 April 2015 / Revised: 27 May 2015 / Accepted: 5 June 2015 / Published: 18 June 2015
(This article belongs to the Collection Botulinum Toxins on Human Pain)
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Chronic pelvic pain (CPP) is defined as pain in the pelvic organs and related structures of at least 6 months’ duration. The pathophysiology of CPP is uncertain, and its treatment presents challenges. Botulinum toxin A (BoNT-A), known for its antinociceptive, anti-inflammatory, and muscle relaxant activity, has been used recently to treat refractory CPP with promising results. In patients with interstitial cystitis/bladder pain syndrome, most studies suggest intravesical BoNT-A injection reduces bladder pain and increases bladder capacity. Repeated BoNT-A injection is also effective and reduces inflammation in the bladder. Intraprostatic BoNT-A injection could significantly improve prostate pain and urinary frequency in the patients with chronic prostatitis/chronic pelvic pain syndrome. Animal studies also suggest BoNT-A injection in the prostate decreases inflammation in the prostate. Patients with CPP due to pelvic muscle pain and spasm also benefit from localized BoNT-A injections. BoNT-A injection in the pelvic floor muscle improves dyspareunia and decreases pelvic floor pressure. Preliminary studies show intravesical BoNT-A injection is useful in inflammatory bladder diseases such as chemical cystitis, radiation cystitis, and ketamine related cystitis. Dysuria is the most common adverse effect after BoNT-A injection. Very few patients develop acute urinary retention after treatment. View Full-Text
Keywords: interstitial cystitis; chronic prostatitis; pelvic floor interstitial cystitis; chronic prostatitis; pelvic floor

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Jhang, J.-F.; Kuo, H.-C. Novel Treatment of Chronic Bladder Pain Syndrome and Other Pelvic Pain Disorders by OnabotulinumtoxinA Injection. Toxins 2015, 7, 2232-2250.

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