Skip to main content
SpringerLink
Log in

The Effect of Intravesical Capsaicin and Resiniferatoxin in Neurogenic Bladder Dysfunction

  • Chapter
Bladder Disease, Part A

  • 307 Accesses

Abstract

Detrusor hyperreflexia with urge incontinence is a common urological complication in patients with neurological disorders, including multiple sclerosis, cerebrovascular accidents, Parkinson’s disease, spinal cord injuries, and diabetes. Traditionally, treatment of this condition includes oral medication, behavior modification, and occlusive devices, which have limited efficacy. Pharmacologic treatment of the overactive bladder relies on blocking the efferent parasympathetic innervation to the detrusor with anticholinergic drugs. However, these drugs often have troublesome side effects and doses are insufficient to restore continence in patients with detrusor instability. Recently, several studies have shown that intravesical capsaicin may provide a new modality for treatment of functional disorders of the bladder. The first report of intravesical capsaicin to treat hypersensitive bladder was published in 1989 by Maggi et al who reported the existence of capsaicin sensitive afferents in the human bladder.44 This was followed by clinical studies, which have shown the efficacy of intravesical instillation of capsaicin in treatment of neurogenic bladder disorders with detrusor hyperreflexia or hypersensitivity.2,13,18,23,25,30,45

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Avelino A, Cruz F, Coimbra A: Lidocaine prevents noxious excitation of bladder afferents induced by intravesical capsaicin without interfering with the ensuing sensory desensitization: an experimental study in the rat. J Urol, 159:567, 1998.

    Article  PubMed  CAS  Google Scholar 

  2. Barbanti G, Maggi A, Beneforti P, Baroldi P, Turini D: Relief of pain following intravesical capsaicin in patients with hypersensitive disorders of the lower urinary tract. Br J Urol, 71:686, 1993.

    Article  PubMed  CAS  Google Scholar 

  3. Birder LA, Kanai AJ, de Goat WC: DMSO: effect on bladder afferent neurons and nitric oxide release. J Urol, 158:1989, 1997.

    Article  PubMed  CAS  Google Scholar 

  4. Buck SH, Burka TF.: The neuropharmacology of capsaicin: review of some recent observations. Pharmacol Rev, 38:179, 1986.

    PubMed  CAS  Google Scholar 

  5. Byrne DS, Das A, Sedor J, Huang B, Rivas DA, Flood HJ, et al: Effect of intravesical capsaicin and vehicle on bladder integrity control and spinal cord injured rats. J Urol, 159:1074, 1998.

    Article  PubMed  CAS  Google Scholar 

  6. Caterina MJ, Schumacher MA, Tominaga M, Rosen TA, Levine JD, Julius D: The capsaicin receptor: a heat-activated ion channel in the pain pathway. Nature, 389:816, 1997.

    Article  PubMed  CAS  Google Scholar 

  7. Chancellor MB, DeGroat WC: Intravesical capsaicin and resiniferatoxin therapy: spicing up the ways to treat the overactive bladder. J Urol, 162:3, 1999.

    Article  PubMed  CAS  Google Scholar 

  8. Chandiramani VA, Peterson T, Duthie GS, Fowler CJ: Urodynamic changes during therapeutic intravesical instillations of capsaicin. Br J Urol, 77:792, 1997.

    Google Scholar 

  9. Cheng CA, Ma CP, de Groat WC: Effect of capsaicin on micturition and associated reflexes in rats. Amer J Physiol, 34(Pt 2):R132, 1993.

    Google Scholar 

  10. Craft RM, Cohen SM, Porreca F.: Long-lasting desensitization of bladder afferents following intravesical resiniferatoxin and capsaicin in the rat. Pain, 61:317, 1995.

    Article  PubMed  CAS  Google Scholar 

  11. Cruz F, Avelino A, Coimbra A: Desensitization follows excitation of bladder primary afferents by intravesical capsaicin, as shown by c-fos activation in the rat spinal cord. Pain, 64:553, 1996.

    Article  PubMed  CAS  Google Scholar 

  12. Cruz F, Guimaraes M, Silva C, Reis M: Suppression of bladder hyperreflexia by intravesical resiniferatoxin. Lancet, 350:640, 1997.

    Article  PubMed  CAS  Google Scholar 

  13. Cruz F, Guimaraes M, Silva C, Rio ME, Coimbra A, Reis M: Desensitization of bladder sensory fibers by intravesical capsaicin has long lasting clinical and urodynamic effects in patients with hyperactive or hypersensitive bladder dysfunction. J Urol, 157:585, 1997.

    Article  PubMed  CAS  Google Scholar 

  14. Das A, Chancellor MB, Watanabe T, Sedor, J, Rivas DA: Intravesical capsaicin in neurogenic impaired patients with detrusor hyperreflexia. Spinal Cord Med, 19:190, 1996.

    CAS  Google Scholar 

  15. Dasgupta P, Chandirmani V, Fowler CJ, Crowe F, Scaravilli F, Beckett A, et al: Intravesical capsaicin: its effect on nerve densities in human urinary bladder. Neurourol Urodyn, 15:373, 1996.

    Google Scholar 

  16. Dasgupta P, Fowler CJ, Stephen R: Electromotive drug adminstration of lidocaine to anesthetize the bladder before intravesical capsaicin. J Urol, 159:1857, 1998.

    Article  PubMed  CAS  Google Scholar 

  17. de Groat WC, Kawatani M, Hisamitsu T, Cheng CL, Ma CP, Thor K,. et al: Mechanisms underlying the recovery of urinary bladder function following spinal cord injury. J Auto Nerv Sys, 30(Suppl):S71, 1990.

    Article  Google Scholar 

  18. DeRidder D, Chyandiramani V, Dasgupt P, Van Poppel H, Baert L, Fowler CJ: Intravesical capsaicin as a treatment for refractory detrusor hyperreflexia: A dual center study with long-term follow-up. J Urol, 158:2087, 1997.

    Article  CAS  Google Scholar 

  19. de-Seze M, Wairt L, Ferriere JM, de-Seze MP, Joseph PA, Barat M: Intravesical instillation of capsaicin in urology: A review of literature. Eur Urol, 36:267, 1999.

    Article  PubMed  CAS  Google Scholar 

  20. Elmahouky A, Elsharaby M: Evaluation of the effect of intravesical capsaicin instillation in patients with detrusor hyperreflexia due to spinal cord injury. Abstract #45. In Bladder Symposium: Bladder disease: Research concepts and clinical application, 1999.

    Google Scholar 

  21. Flood H, Byrne DS, Rivas DA, McCue P, Sedor J, Crewalk JA, et al: Intravesical capsaicin for interstitial cystitis. Abstract 995. J Urol, 157(Pt 2):254A, 1997.

    Google Scholar 

  22. Fowler CA, Beck RO, Gerrard S, Betts CD, Fowler CG: Intravesical capsaicin for treatment of detrusor hyperreflexia. J Neurol Neurosurg Psychiat, 57:169, 1994.

    Article  PubMed  CAS  Google Scholar 

  23. Fowler CJ, Jewkes D, McDonald WI, Lynn B, deGroat WC: Intravesical capsaicin for neurogenic bladder dysfunction (letter). Lancet, 339:1239, 1992.

    Article  PubMed  CAS  Google Scholar 

  24. Geirsson G: Evidence of cold receptors in the human bladder: effect on menthol on the bladder cooling reflex. J Urol, 150:427, 1993.

    PubMed  CAS  Google Scholar 

  25. Geirsson G, Fall M, Sullivan L: Clinical and urodynamic effects of intravesical capsaicin in treatment of patients with chronic traumatic spinal detrusor hyperreflexia. J Urol, 154:1825, 1995.

    Article  PubMed  CAS  Google Scholar 

  26. Ghatei MA, Gu J, Mulderry PK, Bland MA, Allen JM, Marrison JF, et al: Calcitonin-gene-related peptide (CGRP) in the female rat urogenital tract. Peptides, 6:809, 1986.

    Article  Google Scholar 

  27. Habler HJ, Janig W, Koltzenburg M: Activation of unmyelinated afferent fibers by mechanical stimuli and inflammation of the urinary bladder in the cat. J Physiology (Lond), 425:545, 1990.

    CAS  Google Scholar 

  28. Holzer P: Capsaicin: cellular targets, mechanisms of action, and selectivity for thin sensory-neurons. Pharmacol Rev, 43:143, 1991.

    PubMed  CAS  Google Scholar 

  29. Holzer-Petsche U, Lembeck U: Systemic capsaicin treatment impairs the micturition reflex in the rat. Brit J Pharmacol, 83:935, 1984.

    Article  CAS  Google Scholar 

  30. Igawa Y, Komiyama I, Nishizawa S, Ogawa A: Intravesical capsaicin inhibits autonomic dysreflexia in patients with spinal cord injury. Neurourol Urodyn, 15:374, 1996.

    Google Scholar 

  31. Ishizuka O, Mattiasson A, Andersson KE: Urodynamic effect of intravesical resiniferatoxin and capsaicin in conscious rats with and without outflow obstruction. J Urol, 154 611, 1995.

    Article  PubMed  CAS  Google Scholar 

  32. Jancso N, Jancso-Gabor A, Szolcsanyi J: The role of sensory nerve endings in neurogenic inflammation induced in human skin and in the eye and paw of the rat. Brit J Pharmacol, 33:32, 1968.

    PubMed  CAS  Google Scholar 

  33. Jessell TM, Iversen LL, Cuello AC: Capsaicin-induced depletion of substance P from primary sensory neuron. Brain Res, 162:183, 1978.

    Article  Google Scholar 

  34. Kashiba H, Ueda Y, Senba E: Systemic capsaicin in the adult rat differentially affects gene expression for neuropeptides and neurotrophin receptors in primary sensory neurons. Neuroscience, 78:299 1997.

    Google Scholar 

  35. Kawatini M, Whitney T, Booth AM, deGroat WC: Excitatory effect of substance P in parasympathetic ganglia of cat urinary bladder. Amer J Phyiol, 257(Pt 2):R1450, 1989.

    Google Scholar 

  36. Laembeck F: Columbus, capsicum and capsaicin: past, present and future. Acta Physiol Hungerica, 69:265, 1987.

    Google Scholar 

  37. Lazzeri M, Beneforti P, Benaim G, Magi CA, Lecci A, Turini D: Intravesical capsaicin for treatment of severe bladder pain: a randomized placebo controlled study. J Urol, 156:947, 1996.

    Article  PubMed  CAS  Google Scholar 

  38. Lazzeri M, Beneforti P, Turini D: Urodynamic effects of intravesical resiniferatoxin in humans: preliminary results in stable and unstable detrusor. J Urol, 158:2093, 1997.

    Article  PubMed  CAS  Google Scholar 

  39. Lazzeri M, Beneforti R, Turini D, Spinelli, M, Zanollo A: Intravesical resiniferatoxin for the treatment of detrusor hyperreflexia refractory to capsaicin. J Urol 159(Pt 2):83, abstract 316, 1998.

    Article  Google Scholar 

  40. Lewis R: Why red-hot peppers are red-hot. Biophoto Int J, 50:40, 1998.

    Google Scholar 

  41. Maggi CA, Santicioli P, Meli A: The effect of topical capsaicin on rat urinary bladder motility in vivo. Eur J Parmacol, 103:41, 1984.

    Article  CAS  Google Scholar 

  42. Maggi CA, Santicioli P, Giuliani S, Furio M, Meli A: The capsaicin-senstive innervation of the rat urinary bladder: Further studies on mechanisms regulating micturition threshold. J Urol, 136:696, 1986.

    PubMed  CAS  Google Scholar 

  43. Maggi CA, Santicioli P, Patacchini R, Geppetti P, Giuliani S, Astolfi GM, et al: Regional differences in the motor response to Capsaicin in the guinea pig urinary bladder: relative role of pre-and postjunctional factors related to neuropeptide-containing sensory nerves. Neuroscience, 27:675, 1988.

    Article  PubMed  CAS  Google Scholar 

  44. Maggi CA, Barbant G, Santicioli P, Beneforti P, Misuri D, Meli A, et al: Cystometric evidence that capsaicin-sensitive nerves modulate the afferent branch of micturition reflex in humans. J Urol, 142:150, 1989.

    PubMed  CAS  Google Scholar 

  45. Maggi CA: Capsaicin and primary afferent neurons: from basic science to human therapy? J Auto Nerv Syst, 33:1, 1991.

    Article  CAS  Google Scholar 

  46. Maggi CA, Therapeutic potential of capsaicin-like molecules: studies in animals and humans. Life Sci, 51:1777, 1992.

    Article  PubMed  CAS  Google Scholar 

  47. Mallory B, Steers WD, de Groat WC: Electrophysiological study of micturition reflexes in the rat. Am J Physiol, 257:R410, 1989.

    PubMed  CAS  Google Scholar 

  48. Nilsson G, Alving K, Ahlstedt S: Effects of immune responses in rats after neuromanipulation with capsaicin. J Immunopharmacol, 13:21, 1991.

    Article  CAS  Google Scholar 

  49. Nishizawa S, Igawa Y, Okada N, Ohhashi T: Capsaicin induced nitric-oxide-dependent relaxation in isolated dog urethra. Eur J Pharmacol, 335:211, 1997.

    Article  PubMed  CAS  Google Scholar 

  50. Pandita RK, Persson K, Anderesson KE: Capsaicin induced bladder overactivity and nociceptive behavior in conscious rat: involvement of spinal nitric oxide. J Auto Nerv Sys, 67:184, 1997.

    Article  CAS  Google Scholar 

  51. Santicioli P, Maggi CA, Meli A: The effect of capsaicin pretreatment on the cystometrograms of urethrane anesthetized rats. J Urol, 133:700, 1985.

    PubMed  CAS  Google Scholar 

  52. Sharkey KA, Williams RG, Schultzberg M, Dockray GJ: Sensory substance P-enervation of the urinary bladder: possible site of action of capsaicin in causing urine retention in rat. Neuroscience, 18:861, 1983.

    Article  Google Scholar 

  53. Singh A, Natarajen K, Aggarwal BB: Capsaicin (8-methyl-N-vanillyl-6-nonenarnide) is potent inhibitor of nuclear transcription factor-kappa B activation by diverse agents. J Immunol, 157:4412, 1996.

    PubMed  CAS  Google Scholar 

  54. Szallasi A: Vanilloid receptors. In: Geppetti P, Holzer P, editors. Neurogenic inflammation. Boca Raton: CRC Press; p. 43–52. 1996.

    Google Scholar 

  55. Szolcsanyi J: Capsaicin-sensitive chemoreceptive neural system with dual sensory-efferent function. In: Chahl LA, Scolcsanyi J, Lembeck F, editors. Antidromic vasodilatation and neurogenic Inflammation. Budapest Akademiai Kiado; p. 26, 1984.

    Google Scholar 

  56. Vaidyanathan S, van Velzen D, Krishnan KR, Parsons KF, Soni BM, Woolfenden A, et al: Nerve fibers in urothelium and submucosa of neuropathic urinary bladder: an immunohistochemical study with S-100 and neurofilament. Paraplegia, 34:137, 1996.

    Article  PubMed  CAS  Google Scholar 

  57. Wiart L, Joseph PA, Petit H, Dosqne JP, de Seze M, Brochet B, et al: The effect of capsaicin on the neurogenic hyperreflexic detrusor. A double blind placebo controlled study in patients with spinal cord disease. Preliminary results. Spinal Cord, 36:95, 1998.

    Article  PubMed  CAS  Google Scholar 

  58. Winter J, Forbes CA, Sternberg J, Lindsay RM: Nerve growth factor (NGF) regulates adult rat cultured dorsal root ganglion neuron responses to the excitotoxin capsaicin. Neuron, 1:973, 1988.

    Article  PubMed  CAS  Google Scholar 

  59. Yoshimura N, Erdman SL, Snider NW, de Groat WC: Effects of spinal cord injury on neurofilament immunoreactivity and capsaicin sensitivity in rat dorsal root ganglion neurons enervating the urinary bladder. Neuroscience, 83:633, 1998.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Tanta University Hospital, Tanta, Egypt

    Ahmed S. El-Mahrouky, Osama M. Elashry & Mahmoud A. Emran

Authors
  1. Ahmed S. El-Mahrouky
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Osama M. Elashry
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mahmoud A. Emran
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Children’s Hospital and Harvard Medical School, Boston, Massachusetts, USA

    Anthony Atala

  2. Ridgefield, Connecticut, USA

    Debra Slade

Rights and permissions

Reprints and permissions

Copyright information

© 2003 Springer Science+Business Media New York

About this chapter

Cite this chapter

El-Mahrouky, A.S., Elashry, O.M., Emran, M.A. (2003). The Effect of Intravesical Capsaicin and Resiniferatoxin in Neurogenic Bladder Dysfunction. In: Atala, A., Slade, D. (eds) Bladder Disease, Part A. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-8889-8_27

Download citation

  • DOI: https://doi.org/10.1007/978-1-4419-8889-8_27

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-4707-1

  • Online ISBN: 978-1-4419-8889-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation