A review of botulinum toxin A for the treatment of neurogenic bladder

Prior to FDA approval of intradetrusor botulinum toxin (BoTA) injections for the treatment of neurogenic bladder, patients had limited treatment options including 'off-label' use of pharmacotherapies (anti-cholinergics, beta agonists, and alpha-blockers) or invasive interventions including bladder augmentation and urinary diversion procedures. Herein, we provide a comprehensive, literature review detailing the salient clinical literature which led to FDA approval of intradetrusor BoTA for neurogenic bladder, Patients with neurogenic detrusor overactivity and detrusor sphincter dyssynergia have been shown in randomized studies to benefit significantly from intradetrusor BoTA injection with regards to the following parameters: improved voided volume, improved bladder pressure and urodynamic parameters, reduced incidence of urinary tract infection, and improved quality of life.

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