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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...
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Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
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Ultrasound-guided Botulinum Toxin-A Injections: A Method of Treating Sialorrhea
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Use of botulinum toxin for voiding dysfunction.

David Eldred-Evans1, Prokar Dasgupta1

  • 1Department of Urology, Medical Research Council (MRC) Centre for Transplantation, King's College London, Guy's Hospital, London, UK.

Translational Andrology and Urology
|May 26, 2017
PubMed
Summary
This summary is machine-generated.

Botulinum toxin A (BoNT-A) effectively treats refractory neurogenic detrusor overactivity and overactive bladder, with regulatory approval. Evidence for other conditions like IC/BPS and DSD is evolving, while BPH treatment shows no clear benefit.

Keywords:
Botulinum toxin A (BoNT-A)benign prostatic hyperplasia (BPH)detrusor overactivity (DO)interstitial cystitis (IC)overactive bladder (OAB)painful bladder syndrome (PBS)

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Area of Science:

  • Urology
  • Pharmacology
  • Nephrology

Background:

  • Botulinum toxin A (BoNT-A) use is expanding for lower urinary tract conditions.
  • Established applications include neurogenic detrusor overactivity (NDO) and overactive bladder (OAB).
  • Emerging uses involve interstitial cystitis/bladder pain syndrome (IC/BPS), benign prostatic hyperplasia (BPH), and detrusor sphincter dyssynergia (DSD).

Purpose of the Study:

  • To review current indications for BoNT-A in lower urinary tract conditions.
  • To critically evaluate the evidence supporting BoNT-A efficacy in these conditions.

Main Methods:

  • Systematic review of published literature on BoNT-A for lower urinary tract disorders.
  • Analysis of randomized controlled trials (RCTs) and other clinical studies.
  • Assessment of evidence quality and regulatory status for each indication.

Main Results:

  • High-quality evidence supports onabotulinumtoxin A (onaBoNT-A) for NDO and OAB, leading to regulatory approval.
  • Promising, yet preliminary, results for IC/BPS suggest potential as a fourth-line treatment.
  • Limited evidence for DSD and variable results for BPH, with recent RCTs showing no benefit over placebo for BPH.

Conclusions:

  • BoNT-A is a well-established treatment for NDO and OAB.
  • Further high-quality research is needed for IC/BPS and DSD.
  • BoNT-A is not currently recommended for routine BPH treatment.