Relief of Pain following Intravesical Capsaicin in Patients with Hypersensitive Disorders of the Lower Urinary Tract

Authors

  • G. BARBANTI,

    1. Departments of Pharmacology and Clinical Pharmacology, Research Laboratories, A. Menarini Pharmaceuticals, Florence; Department of Urology, University of Ferrara, Ferrara, Italy
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  • C. A. MAGGI,

    Corresponding author
    1. Departments of Pharmacology and Clinical Pharmacology, Research Laboratories, A. Menarini Pharmaceuticals, Florence; Department of Urology, University of Ferrara, Ferrara, Italy
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  • P. BENEFORTI,

    1. Departments of Pharmacology and Clinical Pharmacology, Research Laboratories, A. Menarini Pharmaceuticals, Florence; Department of Urology, University of Ferrara, Ferrara, Italy
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  • P. BAROLDI,

    1. Departments of Pharmacology and Clinical Pharmacology, Research Laboratories, A. Menarini Pharmaceuticals, Florence; Department of Urology, University of Ferrara, Ferrara, Italy
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  • D. TURINI

    1. Departments of Pharmacology and Clinical Pharmacology, Research Laboratories, A. Menarini Pharmaceuticals, Florence; Department of Urology, University of Ferrara, Ferrara, Italy
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C. A. Maggi, Pharmacology Department Research Laboratories, A. Menarini Pharmaceuticals, Via Sette Santi 3, Florence 50131, Italy

Abstract

Summary— We have extended our earlier observations on pain relief produced by intravesical instillation of capsaicin (10 μ.M in saline) in patients with hypersensitive disorders of the lower urinary tract.

Patients in group A (n = 15) received intravesical capsaicin on days 0, 14 and 28: on each occasion the drug produced a warm or burning sensation, reduction in bladder capacity and a delayed, transient improvement or disappearance of symptoms. Patients in group B (n = 5) received intravesical capsaicin (10 μ M at cystometry) 3 times on day 0. The initial sensation of warmth was experienced on each occasion, indicating that no significant desensitisation has been produced by the first instillation. Clinical improvement similar to that found in group A was observed. Three patients (group C) received warm saline (42°C) at cystometry. This produced a pricking sensation, no change at cystometry and no subjective clinical improvement. Apart from the initial sensation of warmth, no patient in group A or B experienced side effects, either local or systemic.

These findings confirm that intravesical instillation of capsaicin has a beneficial effect on patients with hypersensitive bladder disorders. Counter-irritation rather than desensitisation of primary afferents could be a possible mechanism of action. Further studies are needed to establish whether the intravesical administration of capsaicin or capsaicin-like agents represents a new form of treatment for relief of bladder pain.

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