Approach to pharmacotherapy of botulinum toxin A in the field of urology

Hamid Mazdak, Zahra Tolou-Ghamari

Abstract


By altering discharge of neurotransmitter from the end of nerve, the strong toxin that is called botulinum toxin or BTX could results in paralysis of different muscles into the human bodies.However there are seven serotype of botulinum toxin, but only botulimum toxin A (BTX-A) was recommended as the most commonly prescribed of BTX by urologists. When treatment strategy based on use of simultaneous anticholinergics could not meet a satisfactory criterion for pharmacologist, urologist and patients, then it seems that BTX-A expressively could improve urinary incontinence symptoms, urodynamic, and quality of life in patients with both neurogenic and non-neurogenic detrusor activity. Related to its use in urological disorders, it seems that intravesical BTX-A injection is useful in inflammatory bladder disease such as chemical cystitis, radiation cystitis, and ketamine related cystitis. Dysuria and urinary retention could be mentioned as the maximum and minimum reported side-effects after injection. It is prescribed in urinary incontinence that could be a result of urethral underactivity (stress) or bladder overactivity (urge), or a combination of two urethral overactivity/bladder underactivity (overflow incontinence). Hematoma, pain at injection site, intractable headache, ptosis, diplopia and hyperactivity of the local antagonist muscle could be mentioned as the temporary side effects. Dry and red eye, space striving, dry mouth, abdominal turbulences, dysphagia, throatiness and lastly breathing difficulties could be specified as potentially serious events.


Keywords


Botulinum toxin-A, BTX-A, urology, bladder, pharmacotherapy

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References


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