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Botulinum Toxin Promising in Multiple Studies of IC/BPS Patients

Chiu B, Tai HC, Chung SD, Birder LA. Botulinum Toxin A for Bladder Pain Syndrome/Interstitial Cystitis. Toxins (Basel). 2016 Jul 1;8(7). pii: E201. doi: 10.3390/toxins8070201.
In this educational article, the authors review how botulinum toxin is thought to work in interstitial cystitis/bladder pain syndrome(IC/BPS) and analyze the evidence suggesting treatment effectiveness. Botulinum toxin has been used for a variety of conditions, including migraine headaches and nerve pain. In a number of studies, injection of botulinum toxin intravesically (directly to the bladder via a catheter) has shown promise as a treatment for IC/BPS that does not respond to more conventional therapies, though the success rate varies from study to study. Nevertheless, multiple studies do suggest the treatment provides relief of pain, reduction in urgency and frequency, as well as improving bladder capacity and urodynamic parameters. How exactly botulinum toxin works in IC/BPS remains under study, and investigations to date suggest the treatment prevents sensory nerves from releasing inflammatory mediators and peripheral neurotransmitters. Despite the promising potential benefits, to date there have been no high-quality, randomized, placebo-controlled studies that would more conclusively define the role of this treatment in patients with IC/BPS, though the authors say further studies would be warranted.