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World J Nephrol. Mar 6, 2016; 5(2): 195-203
Published online Mar 6, 2016. doi: 10.5527/wjn.v5.i2.195
How botulinum toxin in neurogenic detrusor overactivity can reduce upper urinary tract damage?
Maximilien Baron, Philippe Grise, Jean-Nicolas Cornu
Maximilien Baron, Philippe Grise, Jean-Nicolas Cornu, Department of Urology, Rouen University Hospital, 76031 Rouen Cedex 1, France
Author contributions: Baron M did the literature search and drafted the manuscript; Grise P did the literature search and added critical revision and comments to the manuscript; Cornu JN did the literature search, finalized the manuscript, provided critical revision of intellectual content, and supervised the work.
Conflict-of-interest statement: Maximilien Baron and Philippe Grise declare no conflict of interests for this article. Jean-Nicolas Cornu received research funding from Assistance Publique Hôpitaux de Paris, Oak Ridge Associated Universities, Association Française d’Urologie and GSK. He is a consultant for Bard, AMS, EDAP-TMS, Coloplast, Pfizer, MundiPharma, Astellas, Bouchara-Recordati, Biocompatibles UK, Takeda, Majorelle, Allergan and is a proctor for AMS.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jean-Nicolas Cornu, MD, PhD, Department of Urology, Rouen University Hospital, 1 Rue de Germont, 76031 Rouen Cedex 1, France. jeannicolas.cornu@gmail.com
Telephone: +33-23-2880341 Fax: +33-23-2880441
Received: September 25, 2015
Peer-review started: October 6, 2015
First decision: December 4, 2015
Revised: December 30, 2015
Accepted: January 27, 2016
Article in press: January 29, 2016
Published online: March 6, 2016
Abstract

Intradetrusor injections of botulinum toxin are the cornerstone of medical treatment of neurogenic detrusor overactivity. The primary aim of this treatment is to ensure a low pressure regimen in the urinary bladder, but the mechanisms leading to long-term protection of the urinary tract remain poorly understood. In this paper, we highlight the potential benefits of intradetrusor injections of botulinum toxin regarding local effects on the bladder structures, urinary tract infections, stone disease, vesico ureteral reflux, hydronephrosis, renal function based on a comprehensive literature review.

Keywords: Botulinum toxin, Urinary tract infection, Kidney function, Neurogenic detrusor overactivity, Hydronephrosis, Urolithiasis

Core tip: Intradetrusor injection of botulinum toxin prevent damage of the upper urinary tract via several potential mechanisms including reduction of bladder pressure, urothelium and suburothelium modifications, sensory receptors expression, and hypoxia reduction. These data could explain the favourable effects of intradetrusor injection of botulinum toxin on urinary tract infections, stone disease, vesico ureteral reflux, hydronephrosis, renal function.