ABSTRACT

When injected intramuscularly, Botulinum toxin, is a “ive, presynaptic and reversible neuromuscular blocking agent. Different disciplines have used this toxin to treat muscular hypertonicity. In recent years, urologists have a tendency to use Botulinum toxin especially in neurologically oriented lower urinary tract diseases and functional pathologies like benign prostatic hyperplasia as an effective and less invasive treatment alternative. In a wide variety of patients with bladder outlet obstruction or acontractile bladder, the treatment is based on decreasing the outlet resistance. Spontaneous micturition may be possible if the treatment is successful. Botulinum toxin injection into detrusor muscle, was first applied, in children with meningomyelocele and patients with spinal cord injury, in order to treat neurogenic detrusor overactivity, and satisfactory results were reached. Validated studies have been recently conducted on detrusor sphincter dyssynergia and detrusor overactivity. Further possible indications for use of this toxin in urology are motor and sensory urge urethrospasm spasticity of the pelvic floor chronic prostatic pain. But, for none of these diseases, distinct treatment doses are defined. So to reach a better conclusion, controlled and validated studies with well-defined patient populations are necessary.