Review

Intravesical Instillation of Capsaicin in Urology: A Review of the Literature
Marianne de Sèze^a, Laurent Wiart^b, Jean-Marie Ferrière^c, Mathieu-Panchoa de Sèze^a, Pierre-Alain Joseph^a, Michel Barat<sup>a

a</sup>Service de Rééducation Fonctionnelle Neurologique, Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin Tastet-Girard, Bordeaux;
^bCentre de Rééducation Fonctionnelle de la Tour de Gassies, Bruges, et
^cService de Chirurgie Urologique, Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin, Bordeaux, France

Address of Corresponding Author

Eur Urol 1999;36:267-277 (DOI: 10.1159/000020004)

  Key Words

• Capsaicin
• Intravesical administration
• Bladder diseases
• Urodynamics

  Abstract

Objectives: Interest in the intravesical instillation of capsaicin is growing among urologists. Its efficacy on detrusor hyperreflexia, hypersensitive bladder disorders and bladder pain has been reported in several studies. However, the lack of common evaluation parameters and the absence of consensus concerning a protocol of instillation hamper the interpretation of results. The purpose of this review is to better delineate the indications and optimum protocol for intravesical use of capsaicin. Methods: Eight open and two placebo-controlled human clinical trials were analyzed. All 200 patients involved had lower urinary tract disorders. Results: Clinical or urodynamic symptoms improved in 84.3% of the patients who received intravesical capsaicin for neurogenic hyperreflexic bladder, a significantly greater efficacy than that of placebo. Capsaicin may also be beneficial in patients who have non-neurogenic disorders. Whether or not the patients has a neurologic deficit, side effects appear during and in the period immediately following instillation. Conclusions: Intravesical capsaicin appears to be indicated in neurogenic hyperreflexic bladder, but is less effective against detrusor instability, hypersensitive bladder disorders or pelvic pain. The best instillation protocol and long-term tolerance remain to be established.

  Author Contacts

Marianne de Sèze
Service de Rééducation Fonctionnelle Neurologique
Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin Tastet-Girard
F-33076 Bordeaux Cedex (France)
Tel. +33 5 56 79 55 46, Fax +33 5 56 79 60 06, E-Mail m.deseze@aol.fr

  Article Information

Number of Print Pages : 11
Number of Figures : 0, Number of Tables : 6, Number of References : 19