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Botulinum toxin-A for the treatment of overactive bladder: UK contributions

Seth, JH; Panicker, JN; Fowler, CJ; Dowson, C; Khan, MS; Dasgupta, P; Sahai, A; (2013) Botulinum toxin-A for the treatment of overactive bladder: UK contributions. Journal of Clinical Urology , 6 (2) 77 - 83. 10.1177/2051415812473096. Green open access

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Abstract

Background: Botulinum toxin-A (BoNT/A) is now established second-line management for refractory overactivebladder (OAB) and recognised in many incontinence guidelines and pathways. For those with neurogenic detrusoroveractivity secondary to spinal cord injury or multiple sclerosis, the toxin is currently licensed in certain parts of theworld, including the UK. It is an effective treatment in those in whom antimuscarinics and conservative measures havefailed who have symptoms of OAB and or detrusor overactivity (DO). Methods: Treatment can be given in an outpatient setting and can be administered under local anaesthesia. Its efficacylasts for between six and 12 months. Results: It has an acceptable safety profile with the biggest risk being urinary tract infection and difficulty emptying thebladder, necessitating clean intermittent self-catheterisation (CISC). Medium-term follow-up suggests repeated injectionsare also safe and efficacious. Conclusions: The mechanism of action of the toxin is more complicated than originally thought, and it seems likelythat it affects motor and sensory nerves of the bladder. In the last 10 years much of the progress of this treatment fromearly experimental trials to mainstream clinical use, and a better understanding of how it works in the bladder, are as aresult of research conducted in the UK. This review summarises the significant and substantial evidence for BoNT/A totreat refractory OAB from UK centres. © British Association of Urological Surgeons 2013.

Type: Article
Title: Botulinum toxin-A for the treatment of overactive bladder: UK contributions
Open access status: An open access version is available from UCL Discovery
DOI: 10.1177/2051415812473096
Publisher version: http://dx.doi.org/10.1177/2051415812473096
Language: English
Additional information: This article is distributed under the terms of the Creative Commons Attribution 3.0 License (http://www.creativecommons.org/licenses/by/3.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (http://www.uk.sagepub.com/aboutus/openaccess.htm).
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Department of Neuromuscular Diseases
URI: https://discovery.ucl.ac.uk/id/eprint/1469526
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