Skip to main content

Advertisement

Log in

Botulinum toxin type A may improve bladder function in a rat chemical cystitis model

Urological Research Aims and scope Submit manuscript

Abstract

The purpose of this study was to investigate the effect of botulinum toxin type A on bladder function and histology in a rat chemical cystitis model. The study included 41 female Sprague-Dawley rats with chemical cystitis induced by intravesical instillation of hydrochloric acid. The acid instillation was repeated monthly to maintain chronic inflammation. The treatment group (n=21) received 2–3 units of botulinum toxin type A injected into the bladder detrusor at the 3, 6, 9 and 12 o'clock positions, and the control group (n=20) underwent saline injection into the bladder detrusor at the same positions. Urodynamic studies were performed in all rats before the treatment and at death. The rats were killed at 1 week, 2 weeks, 1 month and 2 months after treatment. The bladders were removed and examined histologically for mast cells and inflammatory changes. The cystometric findings showed that, at the beginning and end of the experiment, the increases in the maximum bladder capacity and compliance were significantly higher in the treatment group than in the control group (P=0.000 and P=0.025, respectively). The histological studies revealed similar mast cell counts and leukocyte infiltration for the treatment and control groups. In conclusion, in this rat chemical cystitis model, botulinum toxin type A injected into the bladder detrusor led to a functional improvement. Thus, botulinum toxin type A injection may be an alternative, minimally invasive choice to other surgical treatment options in the treatment of a chronic inflammatory condition to improve deteriorated bladder function.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.
Fig. 2.
Fig. 3.
Fig. 4.
Fig. 5.
Fig. 6.

References

  1. Anonymous (1991) Clinical use of botulinum toxin. National Institutes of Health Consensus Development Conference Statement, Nov 12–14, 1990. Arch Neurol 48: 1294

    PubMed  Google Scholar 

  2. Awad SA, Al-Zahrani HM, Gajewski JB, Bourque-Kehoe AA (1998) Long-term results and complications of augmentation ileocystoplasty for idiopathic urge incontinence in women. Br J Urol 81: 569

    Article  CAS  PubMed  Google Scholar 

  3. Barbalias GA, Liatsikos EN, Athanasopoulos A, Nikiforidis G (2000) Interstitial cystitis: bladder training with intravesical oxybutynin. J Urol 163: 1818

    CAS  PubMed  Google Scholar 

  4. Bjorling DE, Jerde TJ, Zine MJ, Busser BW, Saban MR, Saban R (1999) Mast cells mediate the severity of experimental cystitis in mice. J Urol 162: 231

    CAS  PubMed  Google Scholar 

  5. Borodic GE, Joseph M, Fay L, Cozzolino D, Ferrante RJ (1990) Botulinum A toxin for the treatment of spasmodic torticollis: dysphagia and regional toxin spread. Head Neck 12: 392

    CAS  PubMed  Google Scholar 

  6. Çayan S, Chermansky C, Schlote N, Sekido N, Nunes L, Dahiya R, Tanagho EA (2002) The bladder acellular matrix graft in a rat chemical cystitis model: functional and histologic evaluation. J Urol 168: 798

    PubMed  Google Scholar 

  7. Elgebaly SA, Allam ME, Walzak MPJr, Oselinsky D, Gillies C, Yamase H (1992) Urinary neutrophil chemotactic factors in interstitial cystitis patients and a rabbit model of bladder inflammation. J Urol 147: 1382

    CAS  PubMed  Google Scholar 

  8. Fowler CJ (2000) Intravesical treatment of overactive bladder. Urology 55 [Suppl 5A]: 60

  9. Gillenwater JY, Wein AJ (1988) Summary of the National Institute of Arthritis, Diabetes, Digestive and Kidney Diseases workshop on interstitial cystitis. J Urol 140: 203

    CAS  PubMed  Google Scholar 

  10. Hohenfellner M, Black P, Linn JF, Dahms SE, Thüroff JW (2000) Surgical treatment of interstitial cystitis in women. Int Urogynecol J 11: 113

    Article  CAS  Google Scholar 

  11. Kirschner J, Berweck S, Mall V, Korinthenberg R, Heinen F (2001) Botulinum toxin treatment in cerebral palsy: evidence for a new treatment option. J Neurol 248 [Suppl 1: 28

    Google Scholar 

  12. McGuire E (1994) Bladder compliance. J Urol 151: 965

    CAS  PubMed  Google Scholar 

  13. Pannek J, Sommerfeld HJ, Bötel U, Senge T (2000) Combined intravesical and oral oxybutynin chloride in adult patients with spinal cord injury. Urology 55: 358

    Article  CAS  PubMed  Google Scholar 

  14. Phelan MW, Franks M, Somogyi GT, Yokoyama T, Fraser MO, Lavelle JP, Yoshimura N, Chancellor MB (2001) Botulinum toxin urethral sphincter injection to restore bladder emptying in men and women with voiding dysfunction. J Urol 165: 1107

    CAS  PubMed  Google Scholar 

  15. Piechota HJ, Gleason CA, Dahms SE, Dahiya R, Nunes LS, Lue TF, Tanagho EA (1999) Bladder acellular matrix graft: in vivo functional properties of the regenerated rat bladder. Urol Res 27: 206

    Article  CAS  PubMed  Google Scholar 

  16. Ratliff TL, Klutke CG, McDougall MM (1994) The etiology of interstitial cystitis. Urol Clin North Am 21: 21

    CAS  PubMed  Google Scholar 

  17. Rivas DA, Chancellor MB, Shupp-Byrne D, Shenot PJ, McHugh K, McCue P (1997) A molecular marker for the development of interstitial cystitis in a rat model: isoactin gene expression. J Urol 157: 1937

    CAS  PubMed  Google Scholar 

  18. Saadia D, Voustianiouk A, Wang AK, Kaufmann H (2001) Botulinum toxin type A in primary palmar hyperhidrosis: randomized, single-blind, two-dose study. Neurology 57: 2095

    CAS  PubMed  Google Scholar 

  19. Sant GR, Theoharides TC (1994) The role of the mast cell in interstitial cystitis. Urol Clin North Am 21: 41

    CAS  PubMed  Google Scholar 

  20. Schurch B, Stöhrer M, Kramer G, Schmid DM, Gaul G, Hauri D (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

    CAS  PubMed  Google Scholar 

  21. Schurch B, Schmid DM, Stohrer M (2001) Treatment of neurogenic incontinence with botulinum toxin A. N Engl J Med 342: 665

    Article  Google Scholar 

  22. Schwantes U, Topfmeier P (1999) Importance of pharmacological and physicochemical properties for tolerance of antimuscarinic drugs in the treatment of detrusor instability and detrusor hyperreflexia—chances for improvement of therapy. Int J Clin Pharmacol Ther 37: 209

    CAS  PubMed  Google Scholar 

  23. Shekarriz B, Upadhyay J, Demirbilek S, Barthold JS, Gonzalez R (2000) Surgical complications of bladder augmentation: comparison between various enterocystoplasties in 133 patients. Urology 55: 123

    Article  CAS  PubMed  Google Scholar 

  24. Simpson LL (1981) The origin, stricture, and pharmacological activity of botulinum toxin. Pharmacol Rev 33: 155

    CAS  PubMed  Google Scholar 

  25. Theoharides TC, Pang X, Letourneau R, Sant GR (1998) Interstitial cystitis: a neuroimmunoendocrine disorder. Ann N Y Acad Sci 840: 619

    CAS  PubMed  Google Scholar 

  26. Zermann DH, Ishigooka M, Schubert J, Schmidt RA (2000) Perisphincteric injection of Botulinum toxin type A: a treatment option for patients with chronic prostatic pain. Eur Urol 38: 393

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgement

The experimental protocol was approved by the Committee on Animal Research at the University of Mersin School of Medicine.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Selahittin Çayan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Çayan, S., Coşkun, B., Bozlu, M. et al. Botulinum toxin type A may improve bladder function in a rat chemical cystitis model. Urol Res 30, 399–404 (2003). https://doi.org/10.1007/s00240-002-0291-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00240-002-0291-0

Keywords

Navigation