[Botulinum toxin in nonneurogenic bladder dysfunction]

Nonneurogenic overactive bladder with or without detrusor overactivity and/or incontinence is a bothersome symptom for many people. Until a few years ago, it could be treated only with anticholinergic drugs or invasive surgery. Intradetrusor injection with botulinum toxin type A is a minimally invasive alternative therapy option for patients who do not respond to or tolerate anticholinergic treatment. This literature overview summarises the relevant articles on this topic over the last 6 years and provides information on the efficacy, adverse events, currently used dosages, and injection techniques. Overall, a favourable initial efficacy has been observed starting around day 4 after injection and can last up to approximately 31 weeks. Depending on the dose, however, elevated postvoid residual volumes should be anticipated and might require clean intermittent self-catheterisation. The use of botulinum toxin in the urinary bladder is still considered off-label.