Related Experiment Video
Updated: Jun 20, 2026
03:26
Detrusor Underactivity Model in Rats by Conus Medullaris Transection
Published on: August 28, 2020
Botulinum toxin and refractory non-neurogenic overactive detrusor
I Ksibi1, A-L Godard, P Azouvi
1institut national d'orthopédie Mohamed Kassab, La Manouba, Tunisia. imeneksibi@yahoo.fr
Annals of Physical and Rehabilitation Medicine
|September 5, 2009
Summary
Botulinum toxin injections offer a promising treatment for non-neurogenic detrusor overactivity (NNDO) refractory to standard medications. This therapy shows significant symptom improvement with manageable side effects, filling a crucial treatment gap.
Area of Science:
- Urology
- Pharmacology
Background:
- Non-neurogenic detrusor overactivity (NNDO) presents a therapeutic challenge, particularly when unresponsive to anticholinergic drugs.
- Existing treatments for refractory NNDO have limitations, creating a need for alternative options.
Purpose of the Study:
- To evaluate the efficacy and value of botulinum toxin as a treatment for non-neurogenic detrusor overactivity (NNDO) refractory to anticholinergic medications.
Main Methods:
- A systematic literature review was conducted using the Medline database.
- Articles in English and French, including meta-analyses, reviews, case studies, and randomized controlled trials, were selected.
Main Results:
- Nineteen publications, including three randomized controlled trials, were analyzed.
- Intradetrusor botulinum toxin injections demonstrated significant improvements in physical symptoms, urodynamic parameters, and quality of life for patients with refractory NNDO.
- The primary side effect observed was dose-dependent urine retention.
Conclusions:
- Botulinum toxin is a valuable therapeutic option for refractory NNDO, bridging the gap between anticholinergics and surgery.
- Preliminary data suggest a promising future for botulinum toxin in urology, warranting further scientific investigation.
Related Concept Videos
01:26Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin
Directly acting muscle relaxants like dantrolene and botulinum toxin (BoNT) have distinct mechanisms and applications. Dantrolene, a hydantoin derivative, acts on the ryanodine receptor (RYR1) in skeletal muscle cells. RYR1 are calcium channels present at the sarcoplasmic reticulum membrane. In response to excitation, they release calcium ions from the sarcoplasmic reticulum to the cytosol. Calcium promotes actin-myosin-mediated contraction of muscles.
The binding of dantrolene to the RYR1...
The binding of dantrolene to the RYR1...
01:31Skeletal Muscle Relaxants: Therapeutic Uses
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx as...
01:17Nondepolarizing (Competitive) Neuromuscular Blockers: Mechanism of Action
Nondepolarizing neuromuscular blockers induce paralysis by competitively blocking nicotinic acetylcholine receptors at the muscle end plate. Examples include pancuronium, mivacurium, vecuronium, and rocuronium. These quaternary ammonium derivatives are administered intravenously, are poorly absorbed, and are excreted via the kidneys.
Competitive antagonists prevent acetylcholine from binding to its receptor, inhibiting membrane depolarization. Without conformational changes or intrinsic...
Competitive antagonists prevent acetylcholine from binding to its receptor, inhibiting membrane depolarization. Without conformational changes or intrinsic...
01:22Botulism
Botulism is a life-threatening neuroparalytic condition caused by botulinum neurotoxin, which is produced by the bacterium Clostridium botulinum, a Gram-positive, spore-forming, obligate anaerobe.In adults, the toxin enters the body in different ways: in foodborne botulism, the preformed toxin is absorbed in the intestine. In wound botulism, spores grow in injured tissue and release the toxin into the blood. Infant botulism differs mechanistically from adult forms. In infants, botulism commonly...
01:27Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions
Nondepolarizing neuromuscular blockers prevent the membrane depolarization of muscle cells and inhibit muscle contraction. These are usually administered with anesthetics to achieve complete muscle relaxation. Upon administration, these drugs first block the small, rapidly contracting muscles of the face and hands, followed by the larger muscles of the trunk and the intercostal muscles. The diaphragm is the last muscle to be affected.
Although all competitive neuromuscular blockers are designed...
Although all competitive neuromuscular blockers are designed...
01:26The Micturition Reflex
Urination, or micturition involves the coordination of the bladder's detrusor muscle and two sphincters to ensure controlled bladder emptying.
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...
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...