Abstract
Recently, intravesical injections of Botulinum toxin type B (BT-B) have been trialled in an attempt to treat detrusor overactivity. Use of Botulinum toxin A (BT.-A), for the same in the past, has been quite successful without many reported side effects. Soon after commencing the clinical use of BT-B, a side effect profile was noticed not reported with BT-A. A total of 20 patients with refractory detrusor overactivity were included in this randomized, double blind, placebo controlled, cross over trial. As per protocol, 5000 MU (1 ml) BT-B diluted to a volume of 20 mls with normal saline were injected in 10 different sites into the detrusor, sparing the trigone. We report four cases of autonomic side effects after these injections which strongly suggest clinically relevant systemic spread of the toxin.
Similar content being viewed by others
References
Hallett M (1999). One man’s poison–clinical applications of botulinum toxin. N Engl J Med. 341: 118
Lew MF (2002). Review of the FDA-approved uses of botulinum toxins, including data suggesting efficacy in pain reduction. Clin J Pain 18: S142
Reitz A, Stöhrer M and Kramer G (2004). European experience of 200 cases treated with botulinum-A toxin injections into the detrusor muscle for urinary incontinence due to neurogenic detrusor overactivity. Eur Urol 45: 510
Schurch B, Stöhrer M and Kramer G (2000). Botulinum-A toxin for treating detrusor hyperreflexia in spinal cord injured patients: a new alternative to anticholinergic drugs? Preliminary results. J Urol 164: 692
Leippold T, Reitz A and Schurch B (2003). Botulinum toxin as a new therapy option for voiding disorders: current state of the art. Eur Urol 44: 165
Schurch B, Schmid DM and Stöhrer M (2000). Treatment of neurogenic incontinence with botulinum toxin A. N Engl J Med 342: 665
Schurch B, Hauri D and Rodic B (1996). Botulinum-A toxin as a treatment of detrusor-sphincter dyssynergia: a prospective study in 24 spinal cord injury patients. J Urol 155: 1023
Harper M, Fowler CJ and Dasgupta P (2004). Botulinum toxin and its applications in the lower urinary tract. BJU Int 93: 702
Dykstra D, Enriquez A and Valley M (2000). Treatment of overactive bladder with botulinum toxin type B: a pilot study. Int Urogynecol J Pelvic floor dysfunct 14: 424
Wyndaele JJ (2002). Muscular weakness as side effect of botulinum toxin injection for neurogenic detrusor overactivity. Spinal cord 40: 599
Dressler D and Benecke R (2003). Autonomic side effects of botulinum toxin type B treatment of cervical dystonia and hyperhidrosis. Eur Neurol 49: 34
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ghei, M., Maraj, B.H., Nathan, S. et al. Autonomic side effects of Botulinum toxin Type B Intravesical injections: Report of 4 cases and review of the literature. Int Urol Nephrol 38, 543–544 (2006). https://doi.org/10.1007/s11255-005-8681-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11255-005-8681-1