Das Botulinumneurotoxin ist das potenteste bekannte Gift. Das vom Erreger Clostridium botulinum gebildete Neurotoxin besteht aus einer schweren Kette, die für die Internalisierung des Toxins ins Zytosol an der Nervenendigung verantwortlich ist, und aus einer leichten Kette, die die Fusion der acetylcholinhaltigen Vesikel mit der Zellmembran und somit dessen Ausschüttung in den synaptischen Spalt verhindert. Die daraus resultierende Chemodenervation nach zystoskopischer Botulinumneurotoxin-Injektion in den Musculus detrusor vesicae führt zu einer eindrücklichen Reduktion der Beschwerden der überaktiven Blase. Klinische Studien zeigen Erfolgsraten zwischen 60 und 96% bei der neurogenen und nicht neurogenen überaktiven Blase. Mit dem Botulinumneurotoxin steht somit in der Urogynäkologie zur Behandlung der überaktiven Blase ein effizientes, nebenwirkungsarmes Medikament zur Verfügung, das durch einen minimal invasiven Eingriff appliziert werden kann.

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