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Botulinum toxin type A: applications in urogynaecology

City Hospital, Birmingham, B18 7QH, UK

Angamuthu S Arunkalaivanan, MD MRCOG

Honorary Senior Lecturer and Consultant Urogynaecologist and Obstetrician, City Hospital, Dudley Road, Birmingham B18 7QH, UK E-mail: anga.arunkalaivanan{at}swbh.nhs.uk (corresponding author)

Although not yet licensed, intradetrusor botulinum toxin type A injection has a potential role in the treatment of urogynaecological conditions, the most important of which is intractable urodynamically-proven detrusor overactivity. This article discusses the mechanism of action, potential indications for use, preoperative management and side effects. The techniques used are also described. Botulinum toxin type A injection has an excellent safety and tolerability profile across a wide range of urological uses, but there is a need for further evaluation with randomised, placebo-controlled trials.

Keywords botulinum toxin-A / detrusor overactivity / detrusor sphincter dyssynergia / interstitial cystitis / neurogenic bladder / pelvic pain