====== Botulinum toxin A ======

[[Botulinum toxin]] A (BTX-A) inhibits [[acetylcholine]] exocytosis from parasympathetic postganglionic nerves to the M2 and M3 receptors of the [[detrusor]], inhibiting detrusor contraction. BTX-A (100– 200u) is injected into the [[detrusor muscle]] during cystoscopy. It decreases overactivity, urgency, and storage pressures
((Weckx F, Tutolo M, De Ridder D, et al. The role of botulinum toxin A in treating neurogenic bladder. Transl Androl Urol. 2016; 5:63–71))

Efficacy lasts 3–12 months and repeat injections are required. Maximum [[Botox]] dose is 360u per 90 day from all sources. Side effects include [[urinary tract infection]] and [[urinary retention]]. In patient not already managed with catheterization, must be aware of the risk of urinary retention and need for temporary catheterization in 2–20% of patients
((Weckx F, Tutolo M, De Ridder D, et al. The role of botulinum toxin A in treating neurogenic bladder. Transl Androl Urol. 2016; 5:63–71)).

This is usually self-limited to weeks or months as the BTX-A wears off
((Weckx F, Tutolo M, De Ridder D, et al. The role of botulinum toxin A in treating neurogenic bladder. Transl Androl Urol. 2016; 5:63–71)).

This is usually self-limited to weeks or months as the BTX-A wears off.