Resiniferatoxin (RTX) May Improve Lower Urinary Tract Symptoms
July 30, 2017
UroToday - Fifteen patients were recruited for an open label study to evaluate the safety and efficacy of a single administration of 100ml of 50nM RTX freshly dissolved in 10% ethanol in saline and administered via intravesical catheter over 2-4 minutes. It was held in the bladder for 30 minutes and then washed out with saline. All patients received intravesical lidocaine with a 20 minute dwell time in the bladder before it was emptied and RTX was administered. Four of the 15 met criteria established by the European Society for the Study of Interstitial Cystitis for interstitial cystitis. All participants were diagnosed with what is characterized as greater than one year of "intractable urgency and frequency, with or without urgency incontinence, and presence of increased bladder sensation but no evidence of detrusor overactivity during standard voiding cystometry"
Apostolidis and colleagues report on results of patient assessment at 1, 3, and 6 months post-treatment. One patient failed at 1 month and dropped out, a second dropped out at 3 months because of partial urinary retention, and a 3'rd did not complete urodynamic follow-up. RTX significantly improved mean cystometric capacity, first desire to void volume, and frequency at all time points. Bladder pain, noted in 7 patients at the start of the study, was improved at the 6 month mark in only 1. Interim points showed improvement in pain in 5 patients at 1 month and 3 patients at 3 months.
The relatively high dose of RTX used was reflected in the fact that severe urge or bladder/urethral pain during instillation resulted in intermittent instillation in 7 patients and inability to complete the full instillation in another 2 patients. Oral analgesics were administered to 4 patients.
This small and uncontrolled study provides evidence that RTX is far from dead, and it is possible that future placebo-controlled trials with variable dosing parameters will reveal a dose and frequency of administration that will ultimately prove to have long-term benefits to this group of patients.
Philip M Hanno MD, MPH
Reference:
European Urology-1349; 2006 prepublication, available on the internet as of May 4, 2006; europeanurology
Link Here.
UroToday - the only urology website with original content global urology key opinion leaders actively engaged in clinical practice.
To access the latest urology news releases from UroToday, go to:
urotoday
Copyright © 2006 - UroToday