J Korean Continence Soc.  2000 Jun;4(1):50-56. 10.5213/jkcs.2000.4.1.50.

Early Experience of Intravesical Capsaicin for Treatment of Detrusor Hyperreflexia in Patients with Spinal Cord Injury

• Kim HG
• Park WH
• Choi YC
• So JG
• Park BJ
• Kim DY
• Lim YS
• Shim HB

• KMID: 2007967
• DOI: http://doi.org/10.5213/jkcs.2000.4.1.50

Abstract

PURPOSE
The clinical and urodynamic effects of intravesical capsaicin, a neurotoxic substance causing a reversible suppression of unmyelinated C fiber afferent neuronal activity, were investigated for treatment of detrusor hyperreflexia in patients with spinal cord injury.
MATERIALS AND METHODS
Capsaicin solution (2mM) dissolved in 30% alcohol was instilled intravesically in 7 men with detrusor hyperreflexia due to spinal cord injury. Effects on bladder function and subjective symptoms were evaluated before and after intravesical instillation of capsaicin.
RESULTS
Bladder function was improved in all but 1 patient. The improvement was expressed as an increase from 108ml to 270ml in maximal bladder capacity and a decrease from 75cmH2O to 44cmH2O in maximal detrusor pressure. Four patients had subjective improvement following treatment and the effects lasted for 4 to 6 weeks. Immediately after capsaicin instillation the ice water test was negative in 2 patients. Autonomic dysreflexia was observed in 4 patients, suprapubic discomfort in 3 patients and gross hematuria in 1 patient.
CONCLUSION
Intravesical capsaicin seems to be a promising method for treatment of detrusor hyperreflexia, but the general use of intravesical capsaicin was limited due to side effects.

Keyword

Capsaicin; Spinal cord injury; Detrusor hyperreflexia

MeSH Terms

Administration, Intravesical
Autonomic Dysreflexia
Capsaicin*
Hematuria
Humans
Ice
Male
Nerve Fibers, Unmyelinated
Neurons, Afferent
Reflex, Abnormal*
Spinal Cord Injuries*
Urinary Bladder
Urodynamics
Water
Capsaicin
Ice
Water