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Jhang JF, Kuo HC. Botulinum Toxin A and Lower Urinary Tract Dysfunction: Pathophysiology and Mechanisms of Action. Toxins (Basel). 2016 Apr 21;8(4). pii: E120. doi: 10.3390/toxins8040120.
Botulinum toxin is increasingly being applied or studied as a treatment option not only for interstitial cystitis/bladder pain syndrome (IC/BPS), but also for voiding dysfunction and overactive bladder, among other lower urinary tract diseases. This educational article seeks to describe exactly how botulinum toxin is thought to work as a treatment for IC/BPS and other lower urinary tract diseases. The authors do note that botulinum toxin’s benefit in IC/BPS has not been well demonstrated and further studies are needed; however, they also point out that botulinum toxin does have multiple effects which are thought to potentially contribute to benefit in IC/BPS patients, including anti-inflammatory effects, effects on the nervous system, and amelioration of bladder lining dysfunction. While not all IC/BPS patients would benefit from the intervention, it’s hoped that a better understanding of how botulinum toxin works will help doctors more properly select patients who will receive the treatment. To date, the only lower urinary tract disorder where there is very strong evidence that botulinum toxin is effective is in urinary incontinence due to bladder overactivity.