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Urinary Tract pp 345–374Cite as

Modulation of Urinary Bladder Innervation: TRPV1 and Botulinum Toxin A

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Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 2011))

Abstract

The persisting interest around neurotoxins such as vanilloids and botulinum toxin (BoNT) derives from their marked effect on detrusor overactivity refractory to conventional antimuscarinic treatments. In addition, both are administered by intravesical route. This offers three potential advantages. First, intravesical therapy is an easy way to provide high concentrations of pharmacological agents in the bladder tissue without causing unsuitable levels in other organs. Second, drugs effective on the bladder, but inappropriate for systemic administration, can be safely used as it is the case of vanilloids and BoNT. Third, the effects of one single treatment might be extremely longlasting, contributing to render these therapies highly attractive to patients despite the fact that the reasons to the prolonged effect are still incompletely understood. Attractive as it may be, intravesical pharmacological therapy should still be considered as a second-line treatment in patients refractory to conventional oral antimuscarinic therapy or who do not tolerate its systemic side effects. However, the increasing off-label use of these neurotoxins justifies a reappraisal of their pharmacological properties.

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Authors and Affiliations

  1. Institute of Histology and Embryology, Alameda Prof. Hernani Monteiro, 4200-319, Porto, Portugal

    Ana Charrua & António Avelino

  2. IBMC, University of Porto, Rua do Campo Alegre 823, 4150-180, Porto, Portugal

    Ana Charrua, António Avelino & Francisco Cruz

  3. Department of Urology, Hospital de São João, Alameda Prof. Hernani Monteiro, 4200, Porto, Portugal

    Francisco Cruz

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  1. Ana Charrua
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  2. António Avelino
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  3. Francisco Cruz
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Correspondence to Francisco Cruz .

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  1. Wake Forest University, Medical Center Blvd., Winston-Salem, 27157-1088, North Carolina, USA

    Karl-Erik Andersson

  2. Academic Medical Center, Dept. Pharmacology & Pharmacotherapy, University of Amsterdam, Meibergdreef 15, Amsterdam, 1105 AZ, Netherlands

    Martin C. Michel

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Charrua, A., Avelino, A., Cruz, F. (2011). Modulation of Urinary Bladder Innervation: TRPV1 and Botulinum Toxin A. In: Andersson, KE., Michel, M. (eds) Urinary Tract. Handbook of Experimental Pharmacology, vol 2011. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-16499-6_17

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