Intravesical administration of resiniferatoxin for treatment OAB with increased bladder sensation
Abstract: Overactive bladder is one of the most common conditions in women. The prevalence of OAB in women approximately 11.6% to 16.9%. We know neurogenic and idiopathic OAB. Basically, idiopathic OAB can be successful treated with antimuscarinic drug and botulinum toxin. Recent studies showed that OAB with increased bladder sensation (IBS) can be result of urothelium’s GAG-layer impairment. Damage of GAG-layer may lead to injury of lamina propria by the potassium ions. This process, in turn, can lead to growth of demyelinated C-fibres. OAB with IBS is characterized of frequency, decrease of maximal cystometric capacity, decrease of volume first desire to voiding without involuntary detrusor’s contractions. Some trials, showed efficiency of resiniferatoxin (RTX) for desensitisation of the bladder. Unfortunately, indications for using RTX still not clear. We decided to conduct this trial with two aims:
- check NGF as potential biomarker of OAB with increased bladder sensation;
- estimate of RTX efficacy in treatment of OAB with increased bladder sensation.
Methods: There were two groups of participants in the study. All participants sign the written informed consent:
- healthy women – 30 pts (mean age was 22 ± 4);
- women with ‘idiopathic’ OAB – 52 pts (mean age was 33 ± 9) NGF level was measured in the urine in both groups.
Urodynamic study was performed in OAB group. Estimated parameters were:
- first desire to voiding (FDV);
- first involuntary detrusor contraction (FDC);
- maximal cystometric capacity (MCC). Also, all patients filled voiding diary.
On the next stage were included only patients without involuntary detrusor contractions and positive test with cold water, i.e., with increased bladder sensation (22 pts). The patients were equally, randomised divided into two subgroups:
b) placebo (saline).
Patients of RTX group received intravesical RTX (50 nm, 100 ml, or less). Urodynamic study was performed one and three months later, as well as voiding diary was filled.
- NGF level in the group of OAB with increased bladder sensation is higher in compared with OAB + DO group. Perhaps, NGF can be used as biomarker of increased bladder sensation. Nevertheless, Liu showed in his study an opposite results. We need more RCTs.
- Urodynamic’s parameters significantly improved in RTX group by comparison with placebo group. RTX is promised compound for treatment of AB with increased bladder sensation.
Magazine «The Botulinum J.»