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Intravesical botulinum toxin A injections in the treatment of painful bladder syndrome/interstitial cystitis: a systematic review

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Abstract

Introduction and hypothesis

Intravesical botulinum toxin A (BTX-A) is emerging as a potential new treatment for refractory interstitial cystitis (IC). However, there has been conflicting evidence on this treatment's effectiveness. The aim of our systematic review was to assess the effectiveness and adverse effects of intravesical BTX-A in IC.

Methods

Randomised controlled trials (RCTs) and prospective studies of relevance were identified, assessed for inclusion and then analysed by two independent reviewers.

Results

Ten (three RCTs and seven prospective cohort) studies with a total of 260 participants were included. Eight studies reported improvement in symptoms. Urodynamic parameters were variable. Meta-analysis was not performed due to heterogeneity in reporting of outcomes. Some adverse events, e.g. dysuria and voiding difficulty, were noted (19 out of 260 were required to self-catheterise at anytime postoperatively).

Conclusions

The evidence from the studies thus far suggests a trend towards short-term benefit with intravesical BTX-A injections in refractory IC, but further robust evidence should be awaited.

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Abbreviations

BPS:

Bladder pain syndrome

PBS:

Painful bladder syndrome

IC:

Interstitial cystitis

RCT:

Randomised controlled trial

BFLUTS:

Bristol Female Lower Urinary Tract Symptoms Questionnaire

GRA:

Global Response Assessment

IIQ:

Incontinence Impact Questionnaire

ICSI:

Interstitial Cystitis Symptom Index

ICPI:

Interstitial Cystitis Problem Index

KHQ:

King's Health Questionnaire

QoL:

Quality of life

IPPS:

International Prostate Symptom Score

UDI:

Urogenital Distress Inventory

VAS:

Visual Analogue Score

MCC:

Maximum cystometric capacity

FDV:

First desire to void

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Acknowledgements

Derick Yates, medical librarian at BWHFT, did the literature search for us.

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Authors and Affiliations

  1. Birmingham Women’s NHS Foundation Trust, Metchley Park Road, Edgbaston, Birmingham, UK, B15 2TG

    Sahithi Tirumuru, Deyaa Al-Kurdi & Pallavi Latthe

Authors
  1. Sahithi Tirumuru
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  2. Deyaa Al-Kurdi
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  3. Pallavi Latthe
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Corresponding author

Correspondence to Sahithi Tirumuru.

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Tirumuru, S., Al-Kurdi, D. & Latthe, P. Intravesical botulinum toxin A injections in the treatment of painful bladder syndrome/interstitial cystitis: a systematic review. Int Urogynecol J 21, 1285–1300 (2010). https://doi.org/10.1007/s00192-010-1162-9

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  • DOI: https://doi.org/10.1007/s00192-010-1162-9

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