Purpose: Treatment of interstitial cystitis is usually not successful in eradicating bladder pain and increased bladder capacity. This study was designed to evaluate the clinical effectiveness of suburothelial injection of botulinum A toxin in patients with chronic interstitial cystitis. Methods: Eight women and 2 men with chronic interstitial cystitis who had failed conventional treatments were enrolled in this study. In 5 patients, 100 units of botulinum A toxin was injected suburothelially into 20 sites, and an additional 100 units was injected into the trigone in the other 5 patients. Therapeutic outcome including functional bladder capacity, number of daily urinations, bladder pain, and urodynamic changes were compared between baseline and 3 months after treatment. Results: In 2 patients bladder pain and urinary frequency were improved 3 months after treatment. Mild difficulty in urination was reported by 7 patients. Functional bladder capacity recorded in a voiding diary was significantly increased (155 ± 26.3 vs. 77 ± 27.1 ml, p < 0.001), and the frequency of daily urinations (18 ± 7.7 vs. 24.2 ± 10.3, p = 0.025) and the pain score (2.4 ± 1.6 vs. 3.2 ± 1.1, p = 0.003) were mildly but significantly reduced after treatment. Only the cystometric capacity improved significantly (287 ± 115 vs. 210 ± 63.8 ml, p = 0.05) in urodynamic results. Trigonal injection had no therapeutic effect on symptom or urodynamic improvement. No adverse effect was reported. Conclusions: The clinical result of suburothelial botulinum A toxin injection was disappointing. None of the patients was symptom free and only a limited improvement in bladder capacity and pain score was achieved in 2 patients.

Keywords:
Botulinum A toxin, Painful bladder syndrome, Urodynamics
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© 2005 S. Karger AG, Basel
2005
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