Botulinum toxin therapy for the management of lower urinary tract symptoms – has this come of age?

Intravesical botulinum toxin A (BTX-A) is used extensively in the management of patients with lower urinary tract symptoms. The most common use in urology is in patients with neurogenic and idiopathic detrusor overactivity, with a recent licence being awarded in the United States for the former indication. Here we present the data investigating its use. Numerous placebo controlled randomised studies have shown excellent efficacy and safety with its use and more recent dosing studies have clarified the optimum doses for both NDO and IDO. Despite these studies several injection parameters should still be defined.