Intravesical injection of botulinum toxin A for treatment of interstitial cystitis/bladder pain syndrome: 13 years of experience

Abstract

Objective To evaluate the efficacy of the intravesical injection of botulinum toxin A (BTX-A) and bladder hydrodistention plus sodium hyaluronate (Cystistat) instillation in patients with interstitial cystitis/bladder pain syndrome (IC/BPS). Methods We retrospectively reviewed 153 women with IC/BPS from January 2003 to December 2015. Of the 153 patients, 77 were treated with BTX-A(group A), the average age was (56.0±4.1) years old. 76 underwent bladder hydrodistention plus sodium hyaluronate (Cystistat) instillation (group B), the average age was (58.0±3.3) years old. The patients were evaluated using the O’Leary-Saint score, visual analog scale pain score, urinary frequency record and quality of life questionnaire before treatment and 1 week, 1, 3, 6 and 12 months after treatment. Results In group A, only 2 had acute urinary retention, 27 received a repeat injection, and 28 were lost to follow-up. In group B, 3 had urinary tract infection, 15 switched to BTX-A injection at 6 months because the treatment of hydrodistention plus Cystistat instillation is not good. 31 were lost to follow-up. BTX-A was shown to remain effective for up to 6 months after treatment. After repeated Chinese BTX-A injections, symptoms improved significantly. Hydrodistention plus Cystistat remained effective for up to 3 months after treatment. Conclusions Intravesical injection of BTX-A is a effective therapeutic option for patients with IC/BPS. The average duration of the effect of one dose of Chinese BTX-A was 6 months. Repeated injection of BTX-A is effective. Key words: Interstitial cystitis/bladder pain syndrome; Botulinum toxin-A; Intravesical injection; Hydrodistention; Sodium hyaluronate