Related Experiment Video
Updated: Sep 20, 2026

Detrusor Underactivity Model in Rats by Conus Medullaris Transection
Published on: August 28, 2020
[Efficacy of botulinum toxin A for the treatment of detrusor hyperreflexia]
P Denys1, A Even-Schneider, I Thiry Escudie
1Service de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, faculté de médecine Paris Ile-de-France ouest, 104, boulevard Raymond-Poincaré, 92380 Garches, France. pierre.denys@rpc.ap-hop-paris.fr
Objective:
To determinate the efficacy of botulinum toxin to treat refractory urinary incontinence due to bladder hyperreflexia.
Method:
The international medical literature was reviewed from the Medline and Pubmed database.
Discussion:
The usual first line treatment of detrusor hyperreflexia is parasympathicolytic drugs and self cathterization. In case of lack of efficacy or severe side effects, a surgical procedure (enterocystoplasty) can be performed. 300 units of Botox injected into the detrusor permit a significant increase of bladder capacity and a significant decrease of maximal detrusor pressure for at last 6 months. But we did not find any double blind controlled studies in this indication and no fundamental studies focused on the mechanism of action of botulinum toxin on the bladder muscle. It is now impossible to conclude on the long term efficacy and toxicity.
Conclusion:
Botulinum toxin injected into the detrusor muscle seems to be an efficient treatment of bladder hyperreflexia for 6 months in patients resistant to parasympathicolytic drugs. Long term efficacy and mechanism of action is actually not known.
Related Concept Videos
Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin
The binding of dantrolene to the RYR1...
Botulism
Skeletal Muscle Relaxants: Therapeutic Uses
The Micturition Reflex
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating urine...
Peripherally and Centrally Acting Muscle Relaxants: A Comparison
Centrally acting muscle relaxants can be further divided into spasmolytic and antispasmodic drugs. Spasmolytic drugs,...
Drugs for Treatment of Diarrhea-Predominant IBS
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
