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Chapter 33 - Botulinum neurotoxin applications in urological disorders

Published online by Cambridge University Press:  05 February 2014

By
Brigitte Schurch  and
Stefano Carda
Edited by
Daniel Truong ,
Dirk Dressler ,
Mark Hallett  and
Christopher Zachary
Brigitte Schurch
Affiliation:
Department of Clinical Neuroscience, Service of Neuropsychology and Neurorehabilitation, Lausanne University Hospital, Lausanne, Switzerland
Stefano Carda
Affiliation:
Department of Clinical Neuroscience Service of Neuropsychology and Neurorehabilitation, Lausanne University Hospital, Lausanne, Switzerland
Daniel Truong
Affiliation:
The Parkinson’s and Movement Disorders Institute, Fountain Valley, California
Dirk Dressler
Affiliation:
Department of Neurology, Hannover University Medical School
Mark Hallett
Affiliation:
George Washington University School of Medicine and Health Sciences, Washington, DC
Christopher Zachary
Affiliation:
Department of Dermatology, University of California, Irvine
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Summary

Introduction

Botulinum neurotoxin (BoNT) is licensed for the treatment of a number of conditions characterized by striated muscle spasticity. However, in recent years, their unlicensed use in the treatment of lower urinary tract conditions has been described (Smith et al., 2004). Chief amongst these are conditions characterized by detrusor overactivity. Treatment of vulvodynia and chronic pelvic pain, benign prostate hyperplasia (BPH) and detrusor sphincter dyssynergia (DSD) are other emerging indications with promising positive results.

Overactive bladder

The International Continence Society (ICS) report of 2002 defined overactive bladder syndrome as urgency, with or without urge incontinence, usually with frequency and nocturia, and in the absence of local pathological or hormonal factors (Abrams et al., 2002). The prevalence in Europe and USA was estimated to be 3% among men 40–44 years of age, 9% among women 40–44 years of age, 42% among men 75 years of age or older and 31% among women 75 years of age or older (Tubaro, 2004). The symptoms of overactive bladder have many potential causes and contributing factors. Urination involves the cerebral cortex, the pons, the spinal cord, the peripheral autonomic, somatic and sensory afferent innervation of the lower urinary tract and the anatomical components of the lower urinary tract itself. Disorders of any of these structures may contribute to the symptoms of overactive bladder (Fig. 33.1).

Type
Chapter
Information
Manual of Botulinum Toxin Therapy , pp. 288 - 294
Publisher: Cambridge University Press
Print publication year: 2014

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References

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