Onabotulinumtoin-A for the treatment of interstitial cystitis refractory to conventional therapy

Wei-Che Wu^a, Shiu-Dong Chung^{a, b}, Hann-Chorng Kuo^b

^a Department of Urology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
^b Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan

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Abstract
Botulinum toxins (BoNTs) are well known for their ability to potently reduce noxious inputs by decreasing neuropeptide release, including glutamate, calcitonin gene-related peptides, and substance P from the central endings of bladder sensory nerves. Bladder pain is associated with interstitial cystitis (IC) and painful bladder syndrome (PBS), which is frequently excruciating and intractable. The use of onabotulinumtoxin A (BoNT-A) to relieve this type of bladder pain has not been well described. This article reviews the procedures and efficacy of intravesical onabotulinumtoxin-A injection as a treatment for IC/PBS that is refractory to conventional therapy.

Keywords
Bladder pain; Botulinum; Interstitial cystitis; Intravesical injection