Karl-Erik Andersson led the review process.
Resiniferatoxin and botulinum toxin type A for treatment of lower urinary tract symptoms†
Version of Record online: 17 AUG 2007
Copyright © 2007 Wiley-Liss, Inc.
Neurourology and Urodynamics
Volume 26, Issue S6, pages 920–927, October 2007
How to Cite
Cruz, F. and Dinis, P. (2007), Resiniferatoxin and botulinum toxin type A for treatment of lower urinary tract symptoms. Neurourol. Urodyn., 26: 920–927. doi: 10.1002/nau.20479
- Issue online: 20 SEP 2007
- Version of Record online: 17 AUG 2007
- Manuscript Accepted: 30 MAY 2007
- Manuscript Received: 28 MAR 2007
- FCT. Grant Number: POCTI/SAU-NEU/55983/2004
- detrusor overactivity;
- interstitial cystitis;
- overactive bladder;
- painful bladder syndrome;
Resiniferatoxin (RTX) and botulinum toxin subtype A (BTX-A) are increasingly viewed as potential treatments for lower urinary tract symptoms (LUTS) refractory to conventional therapy. RTX, a capsaicin analogue devoid of severe pungent properties, acts by desensitizing the transient receptor potential vanilloid type 1 (TRPV1) receptor and inactivating C-fibers. BTX-A cleaves soluble N-ethylmaleimide-sensitive factor attachment protein receptor (SNARE) proteins in afferent and efferent nerve endings, therefore impeding the fusion of synaptic vesicles with the neuronal membrane necessary for the release of neurotransmitters. In patients with neurogenic and idiopathic detrusor overactivity, RTX and BTX-A have been shown to increase the volume to first detrusor contraction, increase bladder capacity, and improve urinary incontinence and quality of life. Recent data also suggest a role for these neurotoxins in treating urgency, the primary symptom in overactive bladder (OAB) syndrome. Furthermore, experimental data strongly support the use of both neurotoxins in the treatment of pain and frequency in patients with interstitial cystitis/painful bladder syndrome (IC/PBS), although the results from available clinical trials for this use are still inconclusive. In spite of promising results overall, it should be made clear that the administration of these neurotoxins is still considered an experimental procedure and that more clinical studies are necessary before a license for their use will be issued by health authorities. Neurourol. Urodynam. 26:920–927, 2007. © 2007 Wiley-Liss, Inc.