Mangera Altaf, Chapple Christopher R
Department of Urology Research, Sheffield Teaching Hospitals NHS, Royal Hallamshire Hospital, UK.
Arch Esp Urol. 2010 Dec;63(10):829-41.
The role of botulinum toxin in the treatment of lower urinary tract disorders has vastly expanded in the last few years. The indications list growing to include conditions ranging from detrusor sphincter dyssynergia, neurogenic and idiopathic detrusor overactivity, painful bladder syndrome and lower urinary tract symptoms consequent upon bladder outflow obstruction. This treatment is minimally invasive, shows a remarkable efficacy and has effects lasting up to one year. We review the latest evidence both basic science and clinical to address some of the key questions regarding this treatment modality. There is an abundance of evidence supporting the efficacy, safety and tolerability of this treatment. However, It is clear that much work is still required to understand the mechanism(s) of action of the toxin and more robust placebo controlled randomised trials need to be undertaken to answer the many remaining questions concerning this novel treatment. Nevertheless this treatment modality has remarkable efficacy and minimal side effects and thus will be a key future treatment option for a wide range of indications.
在过去几年中，肉毒杆菌毒素在治疗下尿路疾病方面的作用已大幅扩展。其适应症范围不断扩大，包括逼尿肌括约肌协同失调、神经源性和特发性逼尿肌过度活动、膀胱疼痛综合征以及膀胱出口梗阻所致的下尿路症状等。这种治疗方式微创，疗效显著，效果可持续长达一年。我们回顾了最新的基础科学和临床证据，以解决有关这种治疗方式的一些关键问题。有大量证据支持这种治疗的有效性、安全性和耐受性。然而，显然仍需要开展大量工作来了解毒素的作用机制，并且需要进行更有力的安慰剂对照随机试验，以回答有关这种新型治疗的许多遗留问题。尽管如此，这种治疗方式疗效显著且副作用极小，因此将成为未来针对广泛适应症的关键治疗选择。
