Intravesical therapy for lower urinary tract symptoms

Intravesical (local) therapy for diseases emanating from the bladder is similar to the commonplace management of ocular diseases using eyedrops. The existing intravesical therapy involves administering dosage forms directly into the bladder (through a catheter). This mode of treatment is routine in the bladder cancer by instillation of bacillus Calmette–Guérin to provoke the body's own natural defenses against invasion by proliferating cancer cells in the bladder. Although convenient, the conventional routes of administration for treating diseases such as interstitial cystitis/painful bladder syndrome (IC/PBS) and overactive bladder (OAB) are less acceptable to patients owing to side effects, which may further exacerbate the disease symptoms. Intravesical therapy has demonstrated varying degrees of efficacy and safety in treating IC/PBS and OAB. In recent years, intravesical delivery of biotechnological products including neurotoxins using a liposome platform demonstrated immense promise for lower urinary tract symptoms. This review considers the current status of intravesical therapy in lower urinary tract diseases with special attention to novel drug-delivery systems.