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Application of Botulinum Neurotoxin in Lower Urinary Tract Dysfunctions: Where...
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Application of Botulinum Neurotoxin in Lower Urinary Tract Dysfunctions: Where Are We Now? II

A special issue of Toxins (ISSN 2072-6651). This special issue belongs to the section "Bacterial Toxins".

Deadline for manuscript submissions: 30 June 2024 | Viewed by 4052

Special Issue Editor

Prof. Dr. Hann-Chorng Kuo

E-Mail Website
Guest Editor
Department of Urology, Hualien Tzu Chi Hospital, Tzu Chi Medical Foundation, Buddhist Tzu Chi University, Hualien, Taiwan
Interests: botulinum neurotoxin; neurourology; urodynamics; female urology; stress urinary; incontinence; LUTS
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Following on from the first Special Issue on the topic, “Application of Botulinum Neurotoxin in Lower Urinary Tract Dysfunctions: Where Are We Now?”

In recent decades, botulinum toxin A has been widely used in the treatment of several lower urinary tract dysfunctions (LUTDs), such as overactive bladder syndrome (OAB), neurogenic detrusor overactivity (NDO), interstitial cystitis (IC), and voiding dysfunction. Although botulinum toxin A intravesical injection has been approved for OAB and NDO, the other application of this neurotoxin in LUTDs is yet to be approved. Because some clinical experiences of adverse events have limited its wide application, this treatment has gradually been considered as an unpopular procedure for LUTDs. However, evidence has shown that botulinum toxin A has advantages in LUTDs compared with oral pharmacological medications, especially in elderly OAB patients with cognitive dysfunction, patients with bladder neck dysfunction or dysfunctional voiding, idiopathic voiding dysfunction due to poor relaxation of the external sphincter, or intractable bladder pain syndrome due to IC or ketamine-induced cystitis, male patients with lower urinary tract symptoms and a small prostate, and pediatric patients with OAB or dysfunctional voiding. In addition, botulinum toxin A can also be carried across the urothelial barrier with the aid of bladder treatment such as liposomes or low-energy shock waves. There are several LUTDs other than OAB and NDO that can benefit from botulinum toxin A injection or intravesical instillation. This Special Issue welcomes original or review articles that fucus on the novel applications of botulinum toxin A in LUTDs, either in human or animal studies. The collection of this Special Issue of Toxins will provide updated knowledge and information on the current position of botulinum toxin A in functional urology and LUTDs.

Prof. Dr. Hann-Chorng Kuo
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a double-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Toxins is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • overactive bladder
  • interstitial cystitis
  • neurogenic detrusor overactivity
  • voiding dysfunction
  • lower urinary tract symptoms

Published Papers (3 papers)

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Research

12 pages, 839 KiB  
Article
Intravesical Botulinum Toxin Injection Plus Hydrodistention Is More Effective in Patients with Bladder Pain-Predominant Interstitial Cystitis/Bladder Pain Syndrome
by Wan-Ru Yu, Jia-Fong Jhang and Hann-Chorng Kuo
Toxins 2024, 16(2), 74; https://0-doi-org.brum.beds.ac.uk/10.3390/toxins16020074 - 01 Feb 2024
Viewed by 1075
Abstract
Intravesical botulinum toxin A (BoNT-A) injections are included in the interstitial cystitis/bladder pain syndrome (IC/BPS) treatment guidelines. However, the IC phenotype suitable for treatment with BoNT-A has not been clarified. Therefore, we identified the factors influencing treatment outcomes for intravesical BoNT-A injections in [...] Read more.
Intravesical botulinum toxin A (BoNT-A) injections are included in the interstitial cystitis/bladder pain syndrome (IC/BPS) treatment guidelines. However, the IC phenotype suitable for treatment with BoNT-A has not been clarified. Therefore, we identified the factors influencing treatment outcomes for intravesical BoNT-A injections in patients with non-Hunner IC/BPS (NHIC). This retrospective study included patients with NHIC who underwent 100 U BoNT-A intravesical injections over the past two decades. Six months after treatment, treatment outcomes were assessed using the Global Response Assessment (GRA). Outcome endpoints included GRA, clinical symptoms, urodynamic parameters, urine biomarkers, and the identification of factors contributing to satisfactory treatment outcomes. The study included 220 patients with NHIC (42 men, 178 women). The satisfactory group (n = 96, 44%) had significantly higher pain severity scores and IC symptoms index, larger maximum bladder capacity (MBC), and lower 8-isoprostane levels at baseline. Logistic regression revealed that larger MBC (≥760 mL) and bladder pain predominance were associated with satisfactory outcomes after BoNT-A injection. Subjective parameters and pain severity scores improved significantly in patients with bladder pain-predominant IC/BPS after BoNT-A injection. Thus, NHIC patients with bladder or pelvic pain are more likely to experience satisfactory outcomes following intravesical BoNT-A injections. Full article
(This article belongs to the Special Issue Application of Botulinum Neurotoxin in Lower Urinary Tract Dysfunctions: Where Are We Now? II)
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29 pages, 401 KiB  
Article
Quality of Life in Female Patients with Overactive Bladder after Botulinum Toxin Treatment
by Agnieszka A. Licow-Kamińska, Sylwester M. Ciećwież, Magdalena Ptak, Dariusz Kotlęga and Agnieszka Brodowska
Toxins 2024, 16(1), 7; https://0-doi-org.brum.beds.ac.uk/10.3390/toxins16010007 - 21 Dec 2023
Viewed by 1161
Abstract
Background: Manifestations of OAB can considerably diminish the quality of life. Botulinum toxin has emerged as a valuable treatment option in diseases whose symptoms cannot be controlled adequately with other available therapies. The aim of the present study was to compare the subjective [...] Read more.
Background: Manifestations of OAB can considerably diminish the quality of life. Botulinum toxin has emerged as a valuable treatment option in diseases whose symptoms cannot be controlled adequately with other available therapies. The aim of the present study was to compare the subjective quality of life of patients with OAB before the injection of botulinum toxin and three and six months after the intervention. Methods: This study was based on a diagnostic survey with three validated questionnaires, ICIQ-OAB, ICIQ-OABqol, and ICIQ-LUTSqol, and an additional questionnaire developed by the authors to collect sociodemographic characteristics and selected medical data. Results: This study demonstrated significant differences between pre-treatment scores and those at three and six months post injection. At three and six months after the intervention, mean scores for all three instruments (ICIQ-OAB, ICIQ-OABqol, ICIQ-LUTSqol) were significantly lower than the respective pre-treatment values, implying a significant attenuation of OAB symptoms and their lower impact on the quality of life. However, the severity of OAB symptoms and their impact on the quality of life at six months post intervention were significantly higher than at three months, except for the social interaction domain. Conclusions: Botulinum toxin is an effective treatment for OAB. Full article
(This article belongs to the Special Issue Application of Botulinum Neurotoxin in Lower Urinary Tract Dysfunctions: Where Are We Now? II)
14 pages, 1483 KiB  
Article
Retrospective Observational Study of Treatment Patterns and Efficacy of onabotulinumtoxinA Therapy in Patients with Refractory Overactive Bladder in Clinical Practice
by Kwang Jin Ko and Kyu-Sung Lee
Toxins 2023, 15(5), 338; https://0-doi-org.brum.beds.ac.uk/10.3390/toxins15050338 - 15 May 2023
Viewed by 1171
Abstract
This study aimed to evaluate the treatment patterns and long-term efficacy of onabotulinumtoxinA injections in a clinical setting. This single-center retrospective study was conducted on patients with refractory overactive bladder (OAB) aged 18 years or older who received onabotulinumtoxinA 100 IU administered between [...] Read more.
This study aimed to evaluate the treatment patterns and long-term efficacy of onabotulinumtoxinA injections in a clinical setting. This single-center retrospective study was conducted on patients with refractory overactive bladder (OAB) aged 18 years or older who received onabotulinumtoxinA 100 IU administered between April 2012 and May 2022. The primary endpoint was the treatment pattern, including the retreatment rate and OAB medication prescription pattern. The duration and effectiveness of onabotulinumtoxinA treatment were analyzed using the overactive bladder symptom score and voiding diaries. A total of 216 patients were enrolled in this study, and the overall patient satisfaction rate was 55.1%. After the first injection, 19.9% received a second treatment, and 6.1% received three or more injections. The median duration until the second injection was 10.7 months. Among the patients, 51.4% resumed OAB medications after 2.96 months. The presence of urodynamic detrusor overactivity was observed only in female patients (odds ratio, 23.65; 95% CI, 1.84 to 304.40), which was associated with a good response. In contrast to clinical trials, the degree of improvement and retreatment rate did not meet expectations. Our findings provide valuable insights into the effectiveness of onabotulinumtoxinA injections in patients with refractory OAB symptoms in real-world practice. Full article
(This article belongs to the Special Issue Application of Botulinum Neurotoxin in Lower Urinary Tract Dysfunctions: Where Are We Now? II)
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