Botulinum toxin is a substance produced by Clostridium Botulinum and is responsible for human botulism. This substance is a poison, a neurotoxin, but used in limited quantities it can be a cure for some diseases. It is well connected to a large variety of medical applications. The mechanism of action relies on blocking the acetylcholine at the neuromuscular junction, which blocks the transmission of the nervous impulse with secondary flaccid paralysis. In urology, its role in idiopathic overactive bladder and neurogenic bladder is well known. We performed a thorough review using PubMed and other databases, revising the mechanisms of botulinum toxin action in urologic pathology, treatment procedures and other options. Botulinum toxin is a well-studied substance with a large number of applications in medicine. In urologic pathology, overactive bladder and neurogenic bladder are backed by robust studies that support the therapeutic role of this substance. The toxin has multiple effects, such as inhibition of the nerve growth factor, blocking the bladder sensory afferent pathway and apoptotic effect on the prostate tissue, by inhibiting the substance P, altering the nociceptive pathways. Interstitial cystitis and other rare pathologies show promising results, but further studies are needed. The role of botulinum toxin in benign prostatic hyperplasia is still not elucidated.
Experimental and therapeutic medicine. 2020 Apr 15 [Epub]
Arsenie Dan Spinu, Ovidiu Gabriel Bratu, Camelia Cristina Diaconu, Ana Maria Alexandra Stanescu, Simona Bungau, Ovidiu Fratila, Roxana Bohiltea, Dan Liviu Dorel Mischianu
'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania., Department of Pharmacy, University of Oradea, Faculty of Medicine and Pharmacy, 410028 Oradea, Romania., Department of Medical Disciplines, University of Oradea, Faculty of Medicine and Pharmacy, 410087 Oradea, Romania.