Tzu Chi Medical Journal
Volume 20, Issue 2 , Pages 109-111, June 2008

Neurotoxin Versus Neuromodulation for the Treatment of Refractory Overactive Bladder Syndrome

  • Michael B. Chancellor

      Affiliations

    • Department of Urology, William Beaumont Hospital, Royal Oak, MI, USA
    • Corresponding Author InformationCorresponding author. Department of Urology, William Beaumont Hospital, 438 Medical Office Building, 3535 West 13 Mile Road, Royal Oak, MI 48073, USA
    • ,
  • Frank Costa

      Affiliations

    • Urology Institute of Pittsburgh, Pittsburgh, PA, USA
    • ,
  • Hann-Chorng Kuo

      Affiliations

    • Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan

Received 17 December 2007; received in revised form 2 January 2008; accepted 2 February 2008.

Article Outline

Abstract 

Overactive bladder (OAB) is common and is estimated to affect 16.5% of the adult population. In patients refractory to pharmacotherapy, new treatment modalities, such as neuromodulation and botulinum toxin (BoNT), have had encouraging results. Neuromodulation has promising efficacious results in treating refractory OAB, urinary retention and bowel dysfunction, but the reoperation rate is relatively high, and the full mechanism of action of sacral nerve modulation is incompletely understood. BoNT is another potential alternative to surgical intervention for patients with refractory OAB, neurogenic detrusor overactivity and interstitial cystitis. BoNT-A injection in patients with idiopathic detrusor overactivity have reported increases in cystometric capacity, improved subjective symptoms and urodynamic parameters, and improved quality of life. BoNT injection offers an efficacious, minimally invasive alternative to sacral nerve modulation for the treatment of refractory OAB.

Keywords:  Detrusor overactivity , Neuromodulation , Neurotoxin , Overactive bladder

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Abrams P , Cardozo L , Fall M , et al.   The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society . Neurourol Urodyn . 2002;21:167–178
  2. Brazzelli M , Murray A , Fraser C . Efficacy and safety of sacral nerve stimulation for urinary urge incontinence: a systematic review . J Urol . 2006;175:835–841
  3. Smith CP , Radziszewski P , Borkowski A , Somogvi GT , Boone TB , Chancellor MB . Botulinum toxin A has antinociceptive effects in treating interstitial cystitis . Urology . 2004;64:871–875
  4. Apostolidis A , Dasgupta P , Fowler CJ . Proposed mechanism for the efficacy of injected botulinum toxin in the treatment of human detrusor overactivity . Eur Urol . 2006;49:644–650
  5. Schurch B , de Seze M , Denis P . Botulinum toxin type a is a safe and effective treatment for neurogenic urinary incontinence: results of a single treatment, randomized, placebo controlled 6-month study . J Urol . 2005;174:196–200
  6. Sahai A , Khan MS , Dasgupta P . Efficacy of botulinum toxin-A for treating idiopathic detrusor overactivity: results from a single center, randomized, double-blind, placebo controlled trial . J Urol . 2007;177:2231–2236
  7. Schmid DM , Sauermann P , Werner M . Experience with 100 cases treated with botulinum-A toxin injections in the detrusor muscle for idiopathic overactive bladder syndrome refractory to anticholinergics . J Urol . 2006;176:177–185
  8. Ghei M , Maraj BH , Miller R . Effects of botulinum toxin B on refractory detrusor overactivity: a randomized, double-blind, placebo controlled, crossover trial . J Urol . 2005;174:1873–1877
  9. Smith CP , Nishiguchi J , O'Leary M , Yoshimura N , Chancellor MB . Single-institution experience in 110 patients with botulinum toxin A injection into bladder or urethra . Urology . 2005;65:37–41
  10. Smith CP , Chancellor MB . Simplified bladder botulinumtoxin delivery technique using flexible cystoscope and 10 sites of injection . J Endourol . 2005;19:880–882
  11. Kalsi V , Popat RB , Apostolidis A . Cost-consequence analysis evaluating the use of botulinum neurotoxin-A in patients with detrusor overactivity based on clinical outcomes observed at a single UK centre . Eur Urol . 2006;49:519–527

PII: S1016-3190(08)60019-1

doi:10.1016/S1016-3190(08)60019-1

Tzu Chi Medical Journal
Volume 20, Issue 2 , Pages 109-111, June 2008

Article Tools