[Botulinum toxin in urology. An inventory]

Botulinum toxin (BTX) is highly potent in neurogenic and non-neurogenic voiding disorders. Experience with it in neurourology began 15 years ago in the treatment of neurogenic detrusor-sphincter dyssynergia. Indications were expanded not only to neurogenic detrusor hyperactivity but also to non-neurogenic detrusor hyperactivity, other forms of dysfunctional voiding, and some types of pelvic pain syndrome. Sphincter injections can be recommended for patients with symptomatic post-voiding residual urine due to insufficient detrusor contractility, and detrusor injections can be recommended for patients with neurogenic detrusor hyperactivity in which anticholinergic drugs are not sufficient. Because of the lack of evidence-based studies, botulinum toxin is not approved for urologic use, although there is a desperate need for it.