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Int Urol Nephrol. 2016 Aug;48(8):1215-27. doi: 10.1007/s11255-016-1295-y. Epub 2016 Apr 30.

Efficacy and safety of botulinum toxin injection for interstitial cystitis/bladder pain syndrome: a systematic review and meta-analysis.

Author information

1
Institute for Clinical Molecular Biology Research, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea.
2
Department of Epidemiology and Medical Informatics, Korea University, Seoul, Republic of Korea.
3
Department of Education, College of Education, Jeonju University, Jeonju, Republic of Korea.
4
Department of Urology, Soonchunhyang University School of Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, 140-743, Republic of Korea. piacekjh@hanmail.net.

Abstract

PURPOSE:

To investigate the overall treatment efficacy and safety of botulinum toxin type A (BoNTA) injections compared with placebo in interstitial cystitis/bladder pain syndrome (IC/BPS).

METHODS:

We conducted a systematic review and meta-analysis of the published literature in PubMed, Cochrane Library, and EMBASE on BoNTA use in IC/BPS. Outcome measures included changes of OLS, ICSI, ICPI, VAS, frequency, nocturia, FBC, Qmax, and PVR from baseline and also included adverse events.

RESULTS:

A total of five studies were included, with a total sample size of 252 subjects (133 subjects in the experimental group and 119 subjects in the control group). The duration of follow-up ranged from 8 to 12 weeks. The BoNTA dosage was from 50 to 200 U. The pooled overall SMD in the mean change of VAS for the BoNTA group versus the placebo group was -0.49 (95 % CI -0.74, -0.23). There were also significant improvements in ICPI and frequency. The other outcomes (ICSI, nocturia, Qmax, and FBC) were not statistically different between the two groups.

CONCLUSION:

Although BoNTA is not regulatory approved indication, this first evidence-based systematic review and meta-analysis of BoNTA injection for IC/BPS showed significant differences in efficacy of treatment compared with placebo, especially for pain control, and also showed no differences in the rate of procedure-related adverse events.

KEYWORDS:

Bladder pain syndrome; Botulinum toxin; Interstitial cystitis; Meta-analysis; Placebo

PMID:
27139498
DOI:
10.1007/s11255-016-1295-y
[Indexed for MEDLINE]

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