Role of botulinum toxin in the management of multiple sclerosis lower urinary tract dysfunctions
Authors:
W. Mahfouz; J. Corcos
Authors‘ workplace:
Jewish General Hospital, Canada
; Department of Urology
Published in:
Urol List 2011; 9(3): 53-57
Overview
Lower urinary tract (LUT) dysfunction is common in patients with multiple sclerosis (MS). These patients require specialized care, hospitalization and their management is a great challenge for the treatment team. Throughout the course of their disease, patients are offered different management options for treatment of incontinence and detrusor sphincter dyssynergia (DSD); the mainstay of which is antimuscarinic medications, in combination with clean intermittent self-catheterisation (CISC). The evidence for other alternative strategies aiming at improving bladder emptying is lacking and still needs more clinical trials. Botulinum toxin-A (BonT-A) has been used extensively in the management of urological manifestations of MS; as regard neurogenic detrusor overactivity (NDO) and DSD, with proven efficacy in both entities.This review will focus on the role of BonT-A in management of MS bladder and sphincteric dysfunctions, with emphasis on incidence, presentation, applications and techniques of injection of BonT-A in MS patients.
Key words:
multiple sclerosis, botulinum toxin, neurogenic detrusor overactivity, detrusor sphincter dyssynergia
Sources
1. Habek M, Karni A, Balash Y et al. The place of the botulinum toxin in the management of multiple sclerosis. Clin Neurol Neurosurg 2010; 112(7): 592–596.
2. Nicholas R, Young C, Friede T. Bladder symptoms in multiple sclerosis: a review of pathophysiology and management. Expert Opin Drug Saf 2010; 9(6): 905–915.
3. Detels R, Clark VA, Valdiviezo NL et al. Factors associated with a rapid course of multiple sclerosis. Arch Neurol 1982; 39(6): 337–341.
4. Noonan CW, Williamson DM, Henry JP et al. The prevalence of multiple sclerosis in 3 US communities. Prev Chronic Dis 2010; 7(1): A12.
5. Mehnert U, Birzele J, Reuter K et al. The effect of botulinum toxin type a on overactive bladder symptoms in patients with multiple sclerosis: a pilot study. J Urol 2010; 184(3): 1011–1016.
6. de Seze M, Ruffion A, Denys P et al. The neurogenic bladder in multiple sclerosis: review of the literature and proposal of management guidelines. Mult Scler 2007; 13(7): 915–928.
7. Litwiller SE, Frohman EM, Zimmern PE. Multiple sclerosis and the urologist. J Urol 1999; 161(3): 743–757.
8. Nortvedt MW, Riise T, Frugard J et al. Prevalence of bladder, bowel and sexual problems among multiple sclerosis patients two to five years after diagnosis. Mult Scler 2007; 13(1): 106–112.
9. Panicker JN, Nagaraja D, Kovoor JM et al. Lower urinary tract dysfunction in acute disseminated encephalomyelitis. Mult Scler 2009; 15(9): 1118–1122.
10. Amarenco G, Kerdraon J, Denys P. Bladder and sphincter disorders in multiple sclerosis. Clinical, urodynamic and neurophysiological study of 225 cases. Rev Neurol 1995; 151(12): 722–730.
11. Porru D, Campus G, Garau A et al. Urinary tract dysfunction in multiple sclerosis: is there a relation with disease-related parameters? Spinal Cord 1997; 35(1): 33–36.
12. Abrams P, Cardozo L, Fall M et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 2002; 21(2): 167–178.
13. Giannantoni A, Scivoletto G, Di Stasi SM et al. Urological dysfunctions and upper urinary tract involvement in multiple sclerosis patients. Neurourol Urodyn 1998; 17(2): 89–98.
14. Smith CP, Chancellor MB. Emerging role of botulinum toxin in the management of voiding dysfunction. J Urol 2004; 171 (6 Pt 1): 2128–2137.
15. Jost WH. Botulinum toxin in multiple sclerosis. Journal of neurology 2006; 253 Suppl 1: I16–I20.
16. Yoshimura N, Chancellor MB. Physiology and pharmacology of the bladder and urethra. Saunders Elsevier, Philadelphia 2007.
17. de Seze M, Petit H, Gallien P et al. Botulinum a toxin and detruzor sphincter dyssynergia: a double-blind lidocaine-controlled study in 13 patients with spinal cord disease. Eur Urol 2002; 42(1): 56–62.
18. Dykstra DD, Sidi AA. Treatment of detruzor-sphincter dyssynergia with botulinum A toxin: a double-blind study. Arch Phys Med Rehabil 1990; 71(1): 24–26.
19. Dykstra DD, Sidi AA, Scott AB et al. Effects of botulinum A toxin on detruzor-sphincter dyssynergia in spinal cord injury patients. J Urol 1988; 139(5): 919–922.
20. Gallien P, Robineau S, Verin M et al. Treatment of detruzor sphincter dyssynergia by transperineal injection of botulinum toxin. Arch Phys Med Rehabil 1998; 79(6): 715–717.
21. Petit H, Wiart L, Gaujard E et al. Botulinum A toxin treatment for detruzor-sphincter dyssynergia in spinal cord disease. Spinal Cord 1998; 36(2): 91–94.
22. Phelan MW, Franks M, Somogyi GT et al. Botulinum toxin urethral sphincter injection to restore bladder emptying in men and women with voiding dysfunction. J Urol 2001; 165(4): 1107–1110.
23. Schurch B, Hauri D, Rodic B et al. Botulinum-A toxin as a treatment of detruzor-sphincter dyssynergia: a prospective study in 24 spinal cord injury patients. J Urol 1996; 155(3): 1023–1029.
24. Karsenty G, Baazeem A, Elzayat E et al. Injection of botulinum toxin type A in the urethral sphincter to treat lower urinary tract dysfunction: a review of indications, techniques and results. Can J Urol 2006; 13(2): 3027–3033.
25. Reitz A, Stohrer M, Kramer G et al. European experience of 200 cases treated with botulinum-A toxin injections into the detruzor muscle for urinary incontinence due to neurogenic detruzor overactivity. Eur Urol 2004; 45(4): 510–515.
26. Schurch B, de Seze M, Denys P et al. 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.
27. Chuang YC, Yoshimura N, Huang CC et al. Intravesical botulinum toxin a administration produces analgesia against acetic acid induced bladder pain responses in rats. J Urol 2004; 172 (4 Pt 1): 1529–1532.
28. Dressler D, Adib Saberi F. Botulinum toxin: mechanisms of action. Eur Neurol 2005; 53(1): 3–9.
29. Olsen AL, Benson JT, McClellan E. Urethral sphincter needle electromyography in women: comparison of periurethral and transvaginal approaches. Neurourol Urodyn 1998; 17(5): 531–535.
30. Schurch B, Hodler J, Rodic B. Botulinum A toxin as a treatment of detruzor-sphincter dyssynergia in patients with spinal cord injury: MRI controlled transperineal injections. J Neurol Neurosurg Psychiatry 1997; 63(4): 474–476.
31. Smith CP, Nishiguchi J, O'Leary M et al. Single-institution experience in 110 patients with botulinum toxin A injection into bladder or urethra. Urology 2005; 65: 37–41.
32. Schurch B, Stohrer M, Kramer G et al. Botulinum-A toxin for treating detruzor hyperreflexia in spinal cord injured patients: a new alternative to anticholinergic drugs? Preliminary results. J Urol 2000; 164 (3 Pt 1): 692–697.
33. Popat R, Apostolidis A, Kalsi V et al. A comparison between the response of patients with idiopathic detruzor overactivity and neurogenic detruzor overactivity to the first intradetruzor injection of botulinum-A toxin. J Urol 2005; 174(3): 984–989.
34. Harper M, Popat RB, Dasgupta R et al. A minimally invasive technique for outpatient local anaesthetic administration of intradetruzor botulinum toxin in intractable detruzor overactivity. BJU Int 2003; 92(3): 325–326.
35. Kuo HC. Comparison of effectiveness of detruzor, suburothelial and bladder base injections of botulinum toxin a for idiopathic detruzor overactivity. J Urol 2007; 178 (4 Pt 1): 1359–1363.
36. Smith CP, Chancellor MB. Simplified bladder botulinum-toxin delivery technique using flexible cystoscope and 10 sites of injection. J Endourol 2005; 19(7): 880–882.
37. Dykstra DD, Sidi AA, Scott AB et al. Effects of botulinum A toxin on detruzor-sphincter dyssynergia in spinal cord injury patients. The Journal of urology 1988; 139: 919–922.
38. Litwiller SE, Frohman EM, Zimmern PE. Multiple sclerosis and the urologist. J Urol 1999; 161(5): 743–757.
39. Seze M, Petit H, Gallien P et al. Botulinum a toxin and detruzor sphincter dyssynergia: a double-blind lidocaine-controlled study in 13 patients with spinal cord disease. Eur Urol 2002; 42(1): 56–62.
40. Dykstra DD, Sidi AA. Treatment of detruzor-sphincter dyssynergia with botulinum A toxin: a double-blind study. Arch Phys Med Rehabil 1990; 71(1): 24–26.
41. Gallien P, Reymann JM, Amarenco G et al. Placebo controlled, randomised, double blind study of the effects of botulinum A toxin on detruzor sphincter dyssynergia in multiple sclerosis patients. J Neurol Neurosurg Psychiatry 2005; 76(12): 1670–1676.
42. Gallien P, Robineau S, Verin M et al. Treatment of detruzor sphincter dyssynergia by transperineal injection of botulinum toxin. Arch Physical Med Rehabil 1998; 79(6): 715–717.
43. Petit H, Wiart L, Gaujard E et al. Botulinum A toxin treatment for detruzor-sphincter dyssynergia in spinal cord disease. Spinal Cord 1998; 36(2): 91–94.
44. Schurch B, Hauri D, Rodic B et al. Botulinum-A toxin as a treatment of detruzor-sphincter dyssynergia: a prospective study in 24 spinal cord injury patients. J Urol 1996; 155(3): 1023–1029.
45. Schurch B, Hodler J, Rodic B. Botulinum A toxin as a treatment of detruzor-sphincter dyssynergia in patients with spinal cord injury: MRI controlled transperineal injections. J Neurol Neurosurg Psychiatry 1997; 63(4): 474–476.
46. Wheeler JS Jr., Walter JS, Chintam RS et al. Botulinum toxin injections for voiding dysfunction following SCI. J Spinal Cord Med 1998; 21(3): 227–229.
47. Schulte-Baukloh H, Schobert J, Stolze T et al. Efficacy of botulinum-A toxin bladder injections for the treatment of neurogenic detruzor overactivity in multiple sclerosis patients: an objective and subjective analysis. Neurourol Urodyn 2006; 25(2): 110–115.
48. Kuo HC. Botulinum A toxin urethral injection for the treatment of lower urinary tract dysfunction. J Urol 2003; 170(5): 1908–1912.
49. Liao YM, Kuo HC. Causes of failed urethral botulinum toxin A treatment for emptying failure. Urology 2007; 70(4): 763–766.
50. Schulte-Baukloh H, Weiss C, Stolze T et al. Botulinum-A toxin detruzor and sphincter injection in treatment of overactive bladder syndrome: objective outcome and patient satisfaction. Eur Urol 2005; 48(6): 984–990.
51. Ehren I, Volz D, Farrelly E et al. Efficacy and impact of botulinum toxin A on quality of life in patients with neurogenic detruzor overactivity: a randomised, placebo-controlled, double-blind study. Scand J Urol Nephrol 2007; 41(4): 335–340.
52. Giannantoni A, Di Stasi SM, Nardicchi V et al. Botulinum-A toxin injections into the detruzor muscle decrease nerve growth factor bladder tissue levels in patients with neurogenic detruzor overactivity. J Urol 2006; 175(6): 2341–2344.
53. Giannantoni A, Di Stasi SM, Stephen RL et al. Intravesical resiniferatoxin versus botulinum-A toxin injections for neurogenic detruzor overactivity: a prospective randomized study. J Urology 2004; 172(1): 240–243.
54. Kalsi V, Gonzales G, Popat R et al. Botulinum injections for the treatment of bladder symptoms of multiple sclerosis. Ann Neurol 2007; 62(5): 452–457.
55. Kessler TM, Danuser H, Schumacher M et al. Botulinum A toxin injections into the detruzor: an effective treatment in idiopathic and neurogenic detruzor overactivity? Neurourol Urodyn 2005; 24(3): 231–236.
56. Kim JH, Rivas DA, Shenot PJ et al. Intravesical resiniferatoxin for refractory detruzor hyperreflexia: a multicenter, blinded, randomized, placebo-controlled trial. J Spin Cord Med 2003; 26(4): 358–363.
57. Lekka E, Lee LK. Successful treatment with intradetruzor Botulinum-A toxin for urethral urinary leakage (catheter bypassing) in patients with end-staged multiple sclerosis and indwelling suprapubic catheters. Eur Urol 2006; 50(4): 806–809.
58. Apostolidis A, Dasgupta P, Denys P et al. Recommendations on the use of botulinum toxin in the treatment of lower urinary tract disorders and pelvic floor dysfunctions: a European consensus report. Eur Urol 2009; 55(1): 100–119.
59. Fowler CJ, Panicker JN, Drake M et al. A UK consensus on the management of the bladder in multiple sclerosis. J Neurol Neurosurg Psychiatry 2009; 80(5): 470–477.
Labels
Paediatric urologist UrologyArticle was published in
Urological Journal
![Issue 3](https://www.prolekare.cz/media/cache/resolve/journal_issue/media/image_pdf/9b7f96ba89d2405eca366892ebf1f80e.jpeg)
2011 Issue 3
Most read in this issue
- ILEAL NEOBLADDER AND ITS VARIANTS
- Treatment of muscle-invasive and metastatic bladder cancer – update of the EAU Guidelines
- INTRAVESICAL INSTILLATION THERAPY IN THE TREATMENT OF SUPERFICIAL BLADDER CARCINOMA
- METHODS OF NON-INVASIVE DIAGNOSTICS AND MONITORING OF URINARY BLADDER CANCER