Reproductive Science Section, Cancer Studies and Molecular Medicine, University of Leicester, Leicester Royal Infirmary, Leicester, UK.
World J Urol. 2012 Aug;30(4):451-6. doi: 10.1007/s00345-011-0778-9. Epub 2011 Oct 15.
To review the evidence in support of botulinum toxin (BoNT-A) for overactive bladder and detrusor overactivity in adults.
A search of Medline and Pubmed was undertaken using the search terms 'botulinum toxin' with 'overactive bladder', 'detrusor overactivity', 'randomised trial' and 'trial'. A narrative review was undertaken based on the papers identified.
Only four randomised trials reporting the effects of botulinum toxin in this group of patients exist, alongside three systematic reviews and numerous uncontrolled series. Overall, BoNT-A appears an effective treatment modality, with significant and clinically meaningful reductions in urinary symptoms. Urgency and urgency incontinence episodes appear more responsive than absolute frequency. The side effect profile can be predicted from the mode of action of BoNT-A and includes voiding difficulty and urinary tract infection. Few data exist comparing the efficacy and safety of different doses, nor directly comparing the two common preparations, onabotulintum toxin A with apobotulinum toxin A. The cost-effectiveness of BoNT-A remains to be fully evaluated.
BoNT-A is an emerging treatment for overactive bladder and detrusor overactivity. The data available to date are of moderate quality with few large randomised trials. However, the drug appears to be effective and safe, although further work is required to identify the most cost-effective dose and treatment interval for maximum benefit.
综述支持肉毒毒素（BoNT-A）治疗成人膀胱过度活动症和逼尿肌过度活动的证据。
使用“肉毒毒素”与“膀胱过度活动症”、“逼尿肌过度活动”、“随机试验”和“试验”等搜索词，对 Medline 和 Pubmed 进行了搜索。根据确定的论文进行了叙述性综述。
仅有四项随机试验报告了 BoNT-A 在该组患者中的疗效，同时还有三项系统评价和大量未对照的系列研究。总体而言，BoNT-A 似乎是一种有效的治疗方式，可显著且具有临床意义地减少尿症状。急迫性和急迫性尿失禁发作比绝对频率更敏感。BoNT-A 的作用模式可预测其副作用谱，包括排尿困难和尿路感染。目前尚无关于不同剂量的疗效和安全性的比较数据，也没有直接比较两种常见制剂（onabotulintum 毒素 A 和 apobotulinum 毒素 A）的疗效。BoNT-A 的成本效益仍有待全面评估。
BoNT-A 是治疗膀胱过度活动症和逼尿肌过度活动的一种新兴治疗方法。迄今为止，可用的数据质量中等，大型随机试验较少。然而，该药物似乎是有效且安全的，尽管需要进一步研究以确定最大获益的最具成本效益的剂量和治疗间隔。
