Intravesical instillation of capsaicin in urology: A review of the literature

Objectives: Interest in the intravesical instillation of capsaicin is growi ng among urologists. Its efficacy on detrusor hyperreflexia, hypersensitive bladder disorders and bladder pain has been reported in several studies. H owever, the lack of common evaluation parameters and the absence of consens us concerning a protocol of instillation hamper the interpretation of resul ts. The purpose of this review is to better delineate the indications and o ptimum protocol for intravesical use of capsaicin. Methods: Eight open and two placebo-controlled human clinical trials were analyzed. All 200 patient s involved had lower urinary tract disorders. Results: Clinical or urodynam ic symptoms improved in 84.3% of the patients who received intravesical cap saicin for neurogenic hyperreflexic bladder, a significantly greater effica cy than that of placebo, Capsaicin may also be beneficial in patients who h ave non-neurogenic disorders, Whether or not the patients has a neurologic deficit, side effects appear during and in the period immediately following instillation. Conclusions: Intravesical capsaicin appears to be indicated in neurogenic hyperreflexic bladder, but is less effective against detrusor instability, hypersensitive bladder disorders or pelvic pain, The best ins tillation protocol and long-term tolerance remain to be established.