First experience of the estimation of regional autonomic nervous regulation and blood circulation in the urinary bladder of patients treated by local botulinum toxin injection (lantox)

We investigated regional neurogenic activity and microcirculation state in 5 patients before botulinum toxin injection (Lantox) into detrusor and bladder sphincter and 1 -4 days after injection. A new method of the harmonic analysis of bioimpedance microvariations (approved earlier in the experimental studies) was effectively used to estimate the regional rhythmic activity (due to neurogenic, sympathetic and parasympathetic influence) and vascular activity during treatment. This data shows individual changes in contractile activity, sympathetic / parasympathetic balance in the urinary bladder after botalinum toxine injections, and also amelioration in the regional pulse-induced vascular activity. Quantitative analysis of amplitude / frequency spectra showed that direct action of the toxin was evident as an increase in the neurogenic activity in the majority of the patients, and also the blood circulation improved in 100% of the patients. Depression of parasympathetic activity and shift of the sympathetic / parasympathetic balance to sympathetic influence was present in 60% patients. One of the important effects of the therapy was amelioration of the tonic regulation of local vasculature. Our preliminary data shows that harmonic analysis of bioimpedance microvariations allows to reveal individual features of regulatory disorders in patients with overactive bladder symptoms and also to non-invasively and quantitatively estimate the regional circulation state and autonomic nervous regulation state during the treatment.