Botulinum Toxin Injections in the Bladder and Urethral Sphincter

Intravesical pharmacological therapy for lower urinary tract dysfunction may offer two potential advantages, a high concentration of pharmacological agents directly to the bladder tissue and the possibility of using drugs inappropriate for systemic administration due to off target effects. This is the case of botulinum toxin A (BTX-A). Intravesical pharmacological therapy with this toxin, while highly effective, should still be considered as a second line treatment in patients refractory to oral therapy or that do not tolerate its systemic side effects.