Intravesical therapy options for neurogenic detrusor overactivity.

Détails

ID Serval
serval:BIB_F76ACA6FC529
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
Intravesical therapy options for neurogenic detrusor overactivity.
Périodique
Spinal Cord
Auteur(s)
Reitz A., Schurch B.
ISSN
1362-4393 (Print)
ISSN-L
1362-4393
Statut éditorial
Publié
Date de publication
2004
Volume
42
Numéro
5
Pages
267-272
Langue
anglais
Notes
Publication types: Journal Article ; ReviewPublication Status: ppublish
Résumé
STUDY DESIGN: Review article.
SETTING: Neuro-Urology, Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland.
OBJECTIVES: This review considers intravesical treatment options of neurogenic detrusor overactivity and discusses the underlying mechanism of action, clinical safety and efficacy, and the future trends.
METHODS: The available literature was reviewed using medline services.
RESULTS: Oral anticholinergic drugs are widely used to treat detrusor overactivity, but they are ineffective in some patients or cause systemic side effects such as blurred vision or dry mouth. As an alternative, topical therapy strategies have been suggested to achieve a profound inhibition of the overactive detrusor and to avoid high systemic drug levels. Currently available intravesical treatment options either act on the afferent arc of the reflex such as local anaesthetics or vanilloids or on the efferent cholinergic transmission to the detrusor muscle such as intravesical oxybutynin or botulinum toxin. Although an established and effective therapy, intravesical oxybutynin is not widely used. Evidence for clinical significance of intravesical atropine and local anaesthetic is missing. Intravesical capsaicin has been shown to improve clinical and urodynamic parameters, but cause pain in some patients. The intravesical instillation of resiniferatoxin and the injection of botulinum-A toxin into the detrusor muscle are promising new options; however, randomised placebo-controlled studies to prove their safety and efficacy are still missing.
CONCLUSION: Intravesical treatment strategies in patients with neurogenic detrusor overactivity may provide alternatives to established therapies such as oral anticholinergics. The selectivity of the intravesical treatment and the reduction or even the absence of side effects are major advantages of this topical approach.
Mots-clé
Administration, Intravesical, Botulinum Toxins, Type A/pharmacology, Botulinum Toxins, Type A/therapeutic use, Cholinergic Antagonists/adverse effects, Diterpenes/pharmacology, Diterpenes/therapeutic use, Humans, Muscle Hypertonia/physiopathology, Muscle Hypertonia/therapy, Muscle, Smooth/drug effects, Muscle, Smooth/innervation, Treatment Outcome, Urinary Bladder/drug effects, Urinary Bladder/innervation, Urinary Bladder, Neurogenic/physiopathology, Urinary Bladder, Neurogenic/therapy
Pubmed
Web of science
Open Access
Oui
Création de la notice
05/11/2014 13:12
Dernière modification de la notice
09/05/2019 3:38
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