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High-Level Review of Studies Suggests Promise of Botulinum Toxin for IC/BPS

Wang J, Wang Q, Wu Q, Chen Y, Wu P. Intravesical Botulinum Toxin A Injections for Bladder Pain Syndrome/Interstitial Cystitis: A Systematic Review and Meta-Analysis of Controlled Studies. Med Sci Monit. 2016 Sep 14;22:3257-67.

Numerous studies suggest botulinum toxin A may be effective in controlling symptoms of interstitial cystitis/bladder pain syndrome (IC/BPS); however, many of those studies are not rigorous (e.g., they don’t include a control group for comparative purposes). More recently, higher quality, controlled studies have been published, prompting this research group to conduct a meta-analysis (a study of studies) to evaluate high-level evidence on the efficacy and safety of this treatment. They looked at a total of 7 randomized, controlled trials and one retrospective study. Taken together, the results suggested patients receiving botulinum toxin had a greater reduction in pelvic pain, a significant improvement in urination frequency during the day, and significant improvements in IC/BPS symptoms overall. The trade-off might be a slightly larger volume of post-void residual urine in the treatment group, and no improvements were noted in urinary tract infections, nocturia, dysuria, and urinary flow rate. Taken together, these findings suggest that botulinum toxin injections might be a promising treatment option to improve bladder pain and other aspects of IC/BPS. However, the researchers did emphasize that larger well-designed trials would be needed to confirm these findings.