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Intravesical therapy options for neurogenic detrusor overactivity
André Reitz1, Brigitte Schurch
1Neuro-Urology, Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland.
Spinal Cord
|February 6, 2004
Summary
Intravesical treatments offer alternatives for neurogenic detrusor overactivity, potentially reducing systemic side effects compared to oral anticholinergics. These topical therapies target overactive bladder mechanisms with improved selectivity and safety profiles.
Area of Science:
- Urology
- Neuroscience
- Pharmacology
Background:
- Neurogenic detrusor overactivity (NDO) is a condition affecting bladder control.
- Oral anticholinergic drugs are common but have limitations like systemic side effects and inefficacy in some patients.
Purpose of the Study:
- To review intravesical treatment options for NDO.
- To discuss mechanisms of action, safety, efficacy, and future trends of these treatments.
Main Methods:
- Literature review using Medline services.
- Analysis of available intravesical therapies for NDO.
Main Results:
- Intravesical options include local anesthetics, vanilloids, oxybutynin, and botulinum toxin.
- Intravesical oxybutynin is effective but underutilized.
- Capsaicin shows promise but can cause pain; resiniferatoxin and botulinum-A toxin are emerging options requiring further study.
Conclusions:
- Intravesical treatments provide effective alternatives to oral medications for NDO.
- Key advantages include targeted action and reduced systemic side effects.