The efficacy of botulinum toxin A and sacral neuromodulation in the management of interstitial cystitis (IC)/bladder pain syndrome (BPS), what do we know? ICI-RS 2017 think thank, Bristol

Mohammad S. Rahnama'i*, Tom Marcelissen, Apostolos Apostolidis, Nikolaus Veit-Rubin, Brigitte Schurch, Linda Cardozo, Roger Dmochowski

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

12 Citations (Web of Science)

Abstract

AimsThis manuscript aims to address the evidence availale in the literature on the efficacy of Botulinum Toxin A (BoNT-A) and sacral neuromodulation (SNM) in patients suffering from Interstitial Cystitis (IC)/BPS and propose further research to identify mechanisms of action and establish the clinical efficacy of either therapy. MethodsAt the International Consultation on Incontinence-Research Society (ICI-RS) in 2017, a panel of Functional Urologists and Urogynaecologists participated in a Think Tank (TT) discussing the management of IC/BPS by BoNT-A and SNM, using available data from both PubMed and Medicine literature searches. ResultsThe role of BoNT-A and SNM in the treatment of IC/BPS are discussed and mechanisms of actions are proposed. Despite the available randomized trial data on the effect of intravesical BoNT-A treatment on symptoms of IC/BPS, a consistent conclusion of a positive effect cannot be drawn at the moment, as the published studies are small and heterogeneous in design. There is substantive evidence for the positive effects of SNM on symptoms of IC/BPS patients however, during patient selection, it is important to distinguish the degree and the location of pain in order to tailor the best therapy to the right patients. ConclusionsBoth intravesical BoNT-A treatment and SNM have been shown to have positive effects in patients with IC/BPS. However, firm conclusions cannot yet be drawn. Patient-reported outcomes and quality of life should be assessed in addition to urinary and pain symptoms. Since current treatments mainly focus on symptomatic relief, future research should also focus on clarifying the pathogenic mechanisms involved in IC/BPS.
Original languageEnglish
Pages (from-to)S99-S107
Number of pages9
JournalNeurourology and Urodynamics
Volume37
DOIs
Publication statusPublished - 1 Jun 2018

Keywords

  • botox
  • botulinum toxin A
  • sacral neuromodulation
  • SNM
  • SNS
  • CHRONIC BLADDER INFLAMMATION
  • CHRONIC PELVIC PAIN
  • SYNDROME/INTERSTITIAL CYSTITIS
  • NERVE-STIMULATION
  • DOUBLE-BLIND
  • RAT BLADDER
  • URINARY-BLADDER
  • FOLLOW-UP
  • INJECTIONS
  • WOMEN

Cite this