Abstract
As the intradetrusor injections of BoNT/A remain a minimally invasive with associated patient discomfort and transient injection-related complications, several novel injection-free techniques are being tested in preclinical and clinical studies. These aim at passive diffusion (plain intravesical instillation), disrupting the urothelial barrier (protamine sulfate, dimethyl sulfoxide), increasing urothelial permeability (electromotive drug administration – EMDA, low-energy shock waves – LESW), or transportation via new carrier formulations (liposomes+BoNT/A, thermosensitive hydrogel+BoNT/A, hyaluronic acid+phosphatidylethanolamine+ BoNT/A). Promising, albeit short-lived, results have been reported in small non-neurogenic OAB and interstitial cystitis/bladder pain syndrome studies mostly, with only reports with EMDA existing in neurogenic populations to-date.KeywordsBotulinum toxinBladderDeliveryApplicationHydrogelLiposomeLow-energy shock waves
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