| Abstract [eng] |
Background / objective Botulinum toxin (BTX), the neurotoxin of the anaerobic bacterium Clostridium botulium, specifically inhibits acetylcholine release at motor and vegetative nerve endings. Botulinum toxin-A is available for clinical use (Dysport®). It evokes paresis of the musculature. This paper reviews evidence-based practices in the use of BTX in common urologic conditions. Methods New literature data published in the MEDLINE, urologic journals, 21 studies on the current use of BTX in the treatment of urologic diseases as well as observations on practical application of BTX in the Rouen urologic division, France, in 2004 are reviewed in the article. Results Typically the beneficial effects of external sphincter injections last 3–6 months, while smooth bladder injections tend to persist even longer (4–9 months). Studies give good results in 58–88% (patients with detrusor sphincter dyssynergia), 24–28% patients with overactive bladder, 44–79% with interstitial cystitis, 50–85% with BPH. Conclusion BTX-A has been used with clinical success in urology in the treatment of bladder neurogenic, bladder non-neurogenic, interstitial cystitis and BPH. The studies published so far have demonstrated almost exclusively good results. Various parameters have been evaluated for the assessment of the results, mostly clinical data, residual urine and urodynamic examination. BTX injections are a minimally invasive treatment. |
