Semin Neurol 2016; 36(01): 005-009
DOI: 10.1055/s-0035-1571216
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Botulinum Toxin to Treat Neurogenic Bladder

Christopher P. Smith
1   Scott Department of Urology, Baylor College of Medicine, Houston, Texas
,
Michael B. Chancellor
2   Department of Urology, Director of Neurourology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan
› Author Affiliations
Further Information

Publication History

Publication Date:
11 February 2016 (online)

Abstract

Alteration in neural control from suprapontine areas to the nerves innervating the bladder can lead to bladder dysfunction and the development of a neurogenic bladder (NGB). Patients with NGB often suffer from urinary incontinence, which can lead to adverse events such as urinary tract infections and decubiti, in addition to creating a large care burden for family members or healthcare providers and significantly impairing patient quality of life. The common failure of anticholinergic medications has spurned the development of second-line treatments, including the use of botulinum toxin. OnabotulinumtoxinA (onaBoNT-A; BOTOX, Allergan, Inc.) was approved by the U.S. Food and Drug Administration (FDA) in 2011 to treat neurogenic detrusor overactivity in patients with urinary incontinence resulting from a NGB. In this review the authors summarize pertinent results from key trials leading to FDA approval of onaBoNT-A as well as more recent long-term data.

 
  • References

  • 1 Chancellor MB, Migliaccio-Walle K, Bramley TJ, Chaudhari SL, Corbell C, Globe D. Long-term patterns of use and treatment failure with anticholinergic agents for overactive bladder. Clin Ther 2013; 35 (11) 1744-1751
  • 2 Chancellor MB, Smith CP. Botulinum Toxin in Urology. 1st ed. Heidelberg, Germany: Springer-Verlag; 2011
  • 3 Schurch B, Stöhrer M, Kramer G, Schmid DM, Gaul G, Hauri D. Botulinum-A toxin for treating detrusor hyperreflexia in spinal cord injured patients: a new alternative to anticholinergic drugs? Preliminary results. J Urol 2000; 164 (3 Pt 1): 692-697
  • 4 Schurch B, de Sèze M, Denys P , et al; Botox Detrusor Hyperreflexia Study Team. Botulinum toxin type A is a safe and effective treatment for neurogenic urinary incontinence: results of a single treatment, randomized, placebo controlled 6-month study. J Urol 2005; 174 (1) 196-200
  • 5 Apostolidis A, Thompson C, Yan X, Mourad S. An exploratory, placebo-controlled, dose-response study of the efficacy and safety of onabotulinumtoxinA in spinal cord injury patients with urinary incontinence due to neurogenic detrusor overactivity. World J Urol 2013; 31 (6) 1469-1474
  • 6 Ginsberg D, Gousse A, Keppenne V , et al. Phase 3 efficacy and tolerability study of onabotulinumtoxinA for urinary incontinence from neurogenic detrusor overactivity. J Urol 2012; 187 (6) 2131-2139
  • 7 Chancellor MB, Patel V, Leng WW , et al. OnabotulinumtoxinA improves quality of life in patients with neurogenic detrusor overactivity. Neurology 2013; 81 (9) 841-848
  • 8 Ginsberg D, Cruz F, Herschorn S , et al. OnabotulinumtoxinA is effective in patients with urinary incontinence due to neurogenic detrusor overactivity [corrected] regardless of concomitant anticholinergic use or neurologic etiology. Adv Ther 2013; 30 (9) 819-833
  • 9 Smith CP, Chancellor MB. Emerging role of botulinum toxin in the management of voiding dysfunction. J Urol 2004; 171 (6 Pt 1): 2128-2137
  • 10 Grosse J, Kramer G, Stöhrer M. Success of repeat detrusor injections of botulinum a toxin in patients with severe neurogenic detrusor overactivity and incontinence. Eur Urol 2005; 47 (5) 653-659
  • 11 Del Popolo G, Filocamo MT, Li Marzi V , et al. Neurogenic detrusor overactivity treated with English botulinum toxin A: 8-year experience of one single centre. Eur Urol 2008; 53 (5) 1013-1019
  • 12 Kennelly M, Dmochowski R, Ethans K , et al. Long-term efficacy and safety of onabotulinumtoxinA in patients with urinary incontinence due to neurogenic detrusor overactivity: an interim analysis. Urology 2013; 81 (3) 491-497
  • 13 Rovner E, Kohan A, Chartier-Kastler E , et al. Long-term efficacy and safety of onabotulinumtoxinA in patients with neurogenic detrusor overactivity: analysis among patients who completed 4 years of treatment. J Urol (Suppl) 2015; 193 (4) e35
  • 14 de Paiva A, Meunier FA, Molgó J, Aoki KR, Dolly JO. Functional repair of motor endplates after botulinum neurotoxin type A poisoning: biphasic switch of synaptic activity between nerve sprouts and their parent terminals. Proc Natl Acad Sci U S A 1999; 96 (6) 3200-3205
  • 15 Haferkamp A, Schurch B, Reitz A , et al. Lack of ultrastructural detrusor changes following endoscopic injection of botulinum toxin type a in overactive neurogenic bladder. Eur Urol 2004; 46 (6) 784-791
  • 16 Compérat E, Reitz A, Delcourt A, Capron F, Denys P, Chartier-Kastler E. Histologic features in the urinary bladder wall affected from neurogenic overactivity—a comparison of inflammation, oedema and fibrosis with and without injection of botulinum toxin type A. Eur Urol 2006; 50 (5) 1058-1064
  • 17 Apostolidis A, Jacques TS, Freeman A , et al. Histological changes in the urothelium and suburothelium of human overactive bladder following intradetrusor injections of botulinum neurotoxin type A for the treatment of neurogenic or idiopathic detrusor overactivity. Eur Urol 2008; 53 (6) 1245-1253
  • 18 Jankovic J, Vuong KD, Ahsan J. Comparison of efficacy and immunogenicity of original versus current botulinum toxin in cervical dystonia. Neurology 2003; 60 (7) 1186-1188
  • 19 Schulte-Baukloh H, Bigalke H, Miller K , et al. Botulinum neurotoxin type A in urology: antibodies as a cause of therapy failure. Int J Urol 2008; 15 (5) 407-415 , discussion 415
  • 20 Peyronnet B, Roumiguié M, Castel-Lacanal E , et al. Preliminary results of botulinum toxin A switch after first detrusor injection failure as a treatment of neurogenic detrusor overactivity. Neurourol Urodyn 2014; ; [Epub ahead of print]
  • 21 Nuanthaisong U, Abraham N, Goldman HB. Incidence of adverse events after high doses of onabotulinumtoxinA for multiple indications. Urology 2014; 84 (5) 1044-1048
  • 22 Carlson JJ, Hansen RN, Dmochowski RR, Globe DR, Colayco DC, Sullivan SD. Estimating the cost-effectiveness of onabotulinumtoxinA for neurogenic detrusor overactivity in the United States. Clin Ther 2013; 35 (4) 414-424