El-Khawand Dominique, Wehbe Salim, Whitmore Kristene
Division of Female Pelvic Medicine and Reconstructive Surgery, Drexel University College of Medicine, Philadelphia, PA, USA.
Int Urogynecol J. 2013 Jul;24(7):1073-81. doi: 10.1007/s00192-012-2035-1. Epub 2013 Jan 24.
Botulinum toxin has recently been approved by the Food and Drug Administration (FDA) for the treatment of urinary incontinence associated with neurogenic detrusor overactivity. However, it has also been used off-label for a multitude of other conditions in the female pelvis, including urological, gynecological, and colorectal. This article reviews the most recent data regarding its efficacy and safety, and administration techniques for those conditions.
A literature review of the most relevant reports published between 1985 and 2012.
Urinary incontinence related to neurogenic detrusor overactivity is currently the only approved indication in the female pelvis. Other supported off-label uses include: idiopathic detrusor overactivity, interstitial cystitis/bladder pain syndrome, detrusor sphincter dyssynergia, high-tone pelvic floor dysfunction, anal fissure, anismus, and functional anal pain.
Botulinum toxin may effectively and safely be used in many conditions of the female pelvis. More high quality research is needed to better clarify its role in the therapeutic algorithm for those indications.
肉毒杆菌毒素最近已获美国食品药品监督管理局（FDA）批准，用于治疗与神经源性逼尿肌过度活动相关的尿失禁。然而，它也被用于女性盆腔的多种其他非适应证情况，包括泌尿外科、妇科和结直肠科疾病。本文综述了有关其疗效、安全性以及这些疾病给药技术的最新数据。
对1985年至2012年间发表的最相关报告进行文献综述。
与神经源性逼尿肌过度活动相关的尿失禁目前是女性盆腔唯一获批的适应证。其他得到支持的非适应证用途包括：特发性逼尿肌过度活动、间质性膀胱炎/膀胱疼痛综合征、逼尿肌括约肌协同失调、高张力盆底功能障碍、肛裂、肛门痉挛和功能性肛门疼痛。
肉毒杆菌毒素可有效且安全地用于女性盆腔的多种疾病。需要更多高质量研究以更好地阐明其在这些适应证治疗方案中的作用。
