19537
document
Botulinum toxin a has antinociceptive effects in treating interstitial cystitis . OBJECTIVES To present clinical evidence with botulinum toxin A ( BTX-A ) suggesting an antinociceptive role in patients with interstitial cystitis ( IC ) . Intriguing evidence in a somatic pain model has suggested that BTX-A injection may have an antinociceptive effect on both acute and chronic ( inflammatory ) pain . METHODS Thirteen female patients ( 6 in the United States and 7 in Poland ) with IC according to the criteria of the National Institute of Diabetes , Digestive and Kidney Disease were included . Under short general anesthesia or sedation , 100 to 200 U of Dysport ( Polish patients ) or Botox ( U.S. patients ) was injected through a cystoscope into 20 to 30 sites submucosally in the trigone and floor of the bladder . Patients were evaluated with the O'Leary-Sant validated IC questionnaire or with voiding charts and a visual analog pain scale 1 month postoperatively and at subsequent 3-month intervals . The Polish patients also underwent pretreatment and post-treatment urodynamic evaluations . RESULTS Overall , 9 ( 69 % ) of 13 patients noted subjective improvement after BTX-A treatment . The Interstitial Cystitis Symptom Index and Interstitial Cystitis Problem Index mean scores improved by 71 % and 69 % , respectively ( P < 0.05 ) . Daytime frequency , nocturia , and pain by visual analog scale decreased by 44 % , 45 % , and 79 % , respectively ( P < 0.01 ) . The first desire to void and maximal cystometric capacity increased by 58 % and 57 % , respectively ( P < 0.01 ) . CONCLUSIONS Our results suggest that BTX-A has an antinociceptive effect on bladder afferent pathways in patients with IC , producing both symptomatic and functional ( ie , urodynamic ) improvements .
19538
Intervention_Pharmacological
Botulinum toxin
19539
Intervention_Pharmacological
botulinum toxin A ( BTX-A )
19540
Intervention_Pharmacological
BTX-A injection
19541
Intervention_Pharmacological
Dysport
19542
Intervention_Pharmacological
Botox
19543
Intervention_Pharmacological
BTX-A
19544
Intervention_Pharmacological
BTX-A
19545
Outcome_Physical
antinociceptive effects
19546
Outcome_Pain
antinociceptive role
19547
Outcome_Physical
O'Leary-Sant validated IC questionnaire or with voiding charts
19548
Outcome_Pain
visual analog pain scale
19549
Outcome_Physical
urodynamic evaluations .
19550
Outcome_Other
subjective improvement
19551
Outcome_Physical
Interstitial Cystitis Symptom Index and Interstitial Cystitis Problem Index mean scores
19552
Outcome_Pain
Daytime frequency , nocturia , and pain by visual analog scale
19553
Outcome_Physical
first desire to void and maximal cystometric capacity
19554
Outcome_Pain
antinociceptive effect
19555
Participant_Condition
interstitial cystitis ( IC ) .
19556
Participant_Sample-size
Thirteen
19557
Participant_Sex
female
19558
Participant_Sample-size
6
19559
Participant_Sample-size
7
19560
Participant_Condition
IC
19561
Participant_Condition
100 to 200 U of Dysport
19562
Participant_Condition
Botox