Novel Applications of OnabotulinumtoxinA in Lower Urinary Tract Dysfunction
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 detr...
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doaj-5222313dcc314528b1868260549476b42020-11-24T23:42:23ZengMDPI AGToxins2072-66512018-06-0110726010.3390/toxins10070260toxins10070260Novel Applications of OnabotulinumtoxinA in Lower Urinary Tract DysfunctionJia-Fong Jhang0Hann-Chorng Kuo1Department of Urology, Buddhist Tzu Chi General Hospital, and Tzu Chi University, Hualien 970, TaiwanDepartment of Urology, Buddhist Tzu Chi General Hospital, and Tzu Chi University, Hualien 970, TaiwanOnabotulinumtoxinA (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.http://www.mdpi.com/2072-6651/10/7/260botulinum toxinclinical trialhumanurodynamics |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jia-Fong Jhang Hann-Chorng Kuo |
spellingShingle |
Jia-Fong Jhang Hann-Chorng Kuo Novel Applications of OnabotulinumtoxinA in Lower Urinary Tract Dysfunction Toxins botulinum toxin clinical trial human urodynamics |
author_facet |
Jia-Fong Jhang Hann-Chorng Kuo |
author_sort |
Jia-Fong Jhang |
title |
Novel Applications of OnabotulinumtoxinA in Lower Urinary Tract Dysfunction |
title_short |
Novel Applications of OnabotulinumtoxinA in Lower Urinary Tract Dysfunction |
title_full |
Novel Applications of OnabotulinumtoxinA in Lower Urinary Tract Dysfunction |
title_fullStr |
Novel Applications of OnabotulinumtoxinA in Lower Urinary Tract Dysfunction |
title_full_unstemmed |
Novel Applications of OnabotulinumtoxinA in Lower Urinary Tract Dysfunction |
title_sort |
novel applications of onabotulinumtoxina in lower urinary tract dysfunction |
publisher |
MDPI AG |
series |
Toxins |
issn |
2072-6651 |
publishDate |
2018-06-01 |
description |
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. |
topic |
botulinum toxin clinical trial human urodynamics |
url |
http://www.mdpi.com/2072-6651/10/7/260 |
work_keys_str_mv |
AT jiafongjhang novelapplicationsofonabotulinumtoxinainlowerurinarytractdysfunction AT hannchorngkuo novelapplicationsofonabotulinumtoxinainlowerurinarytractdysfunction |
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