What is the role of botulinum toxin (BTX) injection for the treatment of interstitial cystitis (IC)?

Updated: Jun 19, 2018
  • Author: Anthony H Wheeler, MD; Chief Editor: Meda Raghavendra (Raghu), MD  more...
  • Print
Answer

Answer

Liu et al reported their observations regarding the level of nerve growth factor (NGF) mRNA in bladder tissue and the effect of BTX-A treatment in patients with interstitial cystitis (IC). [91] Nineteen patients with IC underwent intravesical injections of 100 U or 200 U of BTX-A, followed by cystoscopic hydrodistension 2 weeks later. The bladder mucosa was biopsied before BTX-A injections and immediately after hydrodistension in study participants and in 12 control subjects. The NGF mRNA and protein levels in bladder tissues were assessed by real-time polymerase chain reaction and immunohistochemistry studies to determine differences in NGF expression between patients with IC before and after BTX-A treatment and compared with controls.

At 3 months, 14 patients had symptomatic improvement (responders) and 5 did not (nonresponders). At baseline, the NGF mRNA levels in the overall IC patient group were significantly greater than controls. At 2 weeks after BT-XA treatment, the NGF mRNA levels were found to be decreased and were not significantly different from the NGF mRNA levels in controls. The NGF mRNA levels decreased significantly in responders and were significantly decreased after BTX-A in 11 patients who reported a reduction in pain of 2 or more as measured by VAS.

Immunoreactivity studies of bladder tissue from patients with IC showed greater NGF density at baseline compared with controls, but the difference was no longer significant after successful BTX-A treatment. The authors suggest that intravesical BTX-A injections plus hydrodistension reduce bladder pain in patients with IC. The NGF levels in bladder tissues were significantly increased in patients with IC and dropped to normal levels after treatment in responders.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!