Low energy shock wave‐delivered intravesical botulinum neurotoxin‐A potentiates antioxidant genes and inhibits proinflammatory cytokines in rat model of overactive bladder

• Published in: Neurourology and urodynamics 2020-11, Vol.39 (8), p.2447-2454
• Main Authors: Nageib, Mohammed, Zahran, Mohamed H., El‐Hefnawy, Ahmed S., Barakat, Nashwa, Awadalla, Amira, Aamer, Haytham G., Khater, S., Shokeir, Ahmed A.
• Format: Article
• Language: English
• Subjects: acute urine retention (AUR); Administration, Intravesical; Animals; Antioxidants; Bladder; botulinum neurotoxin‐A (BoNT‐A); Botulinum toxin; Botulinum Toxins, Type A - administration & dosage; Botulinum Toxins, Type A - therapeutic use; cystometrogram (CMG); Cytokines; Cytokines - metabolism; Edema; Inflammation; Inflammation - metabolism; Interleukin-6 - metabolism; interleukin‐6 (IL‐6); low energy shock wave (LESW); Malondialdehyde; Mucosa; overactive bladder (OAB); Oxidative stress; Permeability; Rats; Rats, Sprague-Dawley; Statistical analysis; Superoxide dismutase; Tumor necrosis factor; tumor necrotic factor‐α (TNF‐α); Urinary Bladder, Overactive - drug therapy; Urinary Bladder, Overactive - metabolism; Urological Agents - administration & dosage; Urological Agents - therapeutic use; Urothelium - metabolism
• ISSN: 0733-2467; 1520-6777
• DOI: 10.1002/nau.24511

Purpose To study the effect of intravesical instillation of botulinum neurotoxin‐A (BoNT‐A) combined with low energy shock wave (LESW) for treatment of overactive bladder (OAB) in a rat model and to investigate its effect on the associated inflammatory and oxidative stress process. Material and Methods Forty rats were subdivided into four equal groups: normal control group, OAB group, LESW group, and BoNT‐A plus LESW group. Cystometrogram (CMG) changes and histopathological changes in the bladder mucosa were assessed in the different groups. Oxidative stress markers (malondialdehyde [MDA] and superoxide dismutase [SOD]) and proinflammatory cytokines (tumor necrotic factor‐α [TNF‐α] and interleukin‐6 [IL‐6]) were compared among groups. Results BoNT‐A plus LESW group showed statistically significant lower amplitude (p = .001) and lower frequency of detrusor contractions (p = .01) compared to LESW, which showed no statistically significant difference in comparison to the OAB group. Also, the combined group significantly reduced submucosal edema and inflammatory cell infiltrate scores compared to all groups (p