Intravesical Capsaicin as a Therapeutic Option for Bladder Sensory Disorders
Main Article Content
Abstract
Intravesical capsaicin has been used as a treatment for detrusor overactivity and bladder pain syndromes due to its desensitizing effect on C-fiber afferents. However, patient responses vary widely in both efficacy and tolerability. As a therapeutic option, intravesical capsaicin has largely been replaced by botulinum toxin. However, the drug may still be considered in select cases of refractory disease or within the context of research protocols.
Article Details
How to Cite
ANDERSSON, Karl-Erik.
Intravesical Capsaicin as a Therapeutic Option for Bladder Sensory Disorders.
Medical Research Archives, [S.l.], v. 13, n. 9, sep. 2025.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/6940>. Date accessed: 06 dec. 2025.
doi: https://doi.org/10.18103/mra.v13i9.6940.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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17. Abdel-Salam OME, Mózsik G. Capsaicin, The Vanilloid Receptor TRPV1 Agonist in Neuroprotection: Mechanisms Involved and Significance. Neurochem Res. 2023 Nov;48(11):3296-3315. doi: 10.1007/s11064-023-03983-z. Epub 2023 Jul 26. PMID: 37493882; PMCID: PMC10514110.
18. Ramos-Lopez O, Martinez-Aceviz Y, Sobrevilla-Navarro AA, Chavez-Mendez JR. Genetic Influence on Capsaicin Tolerance: Precision Nutrition Implications for Obesity Handling. Lifestyle Genom. 2024;17(1):57-63. doi: 10.1159/000539293. Epub 2024 May 29. PMID: 38810602.
19. Lepiarczyk E, Maździarz M, Paukszto Ł, Bossowska A, Majewski M, Kaleczyc J, Łopieńska-Biernat E, Jaśkiewicz Ł, Skowrońska A, Skowroński MT, Majewska M. Transcriptomic Characterization of the Porcine Urinary Bladder Trigone Following Intravesical Administration of Resiniferatoxin: Insights from High-Throughput Sequencing. Toxins (Basel). 2025 Mar 9;17(3):127. doi: 10.3390/toxins17030127. PMID: 40137900; PMCID: PMC11946646.
20. Szallasi A. Resiniferatoxin: Nature's Precision Medicine to Silence TRPV1-Positive Afferents. Int J Mol Sci. 2023 Oct 10;24(20):15042. doi: 10.3390/ijms242015042. PMID: 37894723; PMCID: PMC10606200.
21. Birder L, Andersson KE. Urothelial signaling. Physiol Rev. 2013 Apr;93(2):653-80. doi: 10.1152/physrev.00030.2012. PMID: 23589830; PMCID: PMC3768101.
22. Lazzeri M, Beneforti P, Turini D. Urodynamic effects of intravesical resiniferatoxin in humans: preliminary results in stable and unstable detrusor. J Urol. 1997 Dec;158(6):2093-6. doi: 10.1016/s0022-5347(01)68164-3. PMID: 9366319.
23. Hamid R, Averbeck MA, Chiang H, Garcia A, Al Mousa RT, Oh SJ, Patel A, Plata M, Del Popolo G. Epidemiology and pathophysiology of neurogenic bladder after spinal cord injury. World J Urol. 2018 Oct;36(10):1517-1527. doi: 10.1007/s00345-018-2301-z. Epub 2018 May 11. PMID: 29752515.
24. Shimizu N, Saito T, Wada N, Hashimoto M, Shimizu T, Kwon J, Cho KJ, Saito M, Karnup S, de Groat WC, Yoshimura N. Molecular Mechanisms of Neurogenic Lower Urinary Tract Dysfunction after Spinal Cord Injury. Int J Mol Sci. 2023 Apr 26;24(9):7885. doi: 10.3390/ijms24097885. PMID: 37175592; PMCID: PMC10177842.
25. Birder LA, de Groat WC. Mechanisms of disease: involvement of the urothelium in bladder dysfunction. Nat Clin Pract Urol. 2007 Jan;4(1):46-54. doi: 10.1038/ncpuro0672. PMID: 17211425; PMCID: PMC3119256.
26. Chandiramani VA, Peterson T, Duthie GS, Fowler CJ. Urodynamic changes during therapeutic intravesical instillations of capsaicin. Br J Urol. 1996 Jun;77(6):792-7. doi: 10.1046/j.1464-410x.1996.09844.x. PMID: 8705210.
27. 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. 1998 Feb;159(2):567-70. doi: 10.1016/s0022-5347(01)63985-5. PMID: 9649293.
2. Andersson KE, Behr-Roussel D, Denys P, Giuliano F. Acute Intravesical Capsaicin for the Study of TRPV1 in the Lower Urinary Tract: Clinical Relevance and Potential for Innovation. Med Sci (Basel). 2022 Sep 10;10(3):50. doi: 10.3390/medsci10030050. PMID: 36135835; PMCID: PMC9504433.
3. Kanai A, Andersson KE. Bladder afferent signaling: recent findings. J Urol. 2010 Apr;183(4):1288-95. doi: 10.1016/j.juro.2009.12.060. Epub 2010 Feb 19. PMID: 20171668; PMCID: PMC3686308.
4. Andersson KE. TRP Channels as Lower Urinary Tract Sensory Targets. Med Sci (Basel). 2019 May 22;7(5):67. doi: 10.3390/medsci7050067. PMID: 31121962; PMCID: PMC6572419.
5. Bielefeldt K, Lamb K, Gebhart GF. Convergence of sensory pathways in the development of somatic and visceral hypersensitivity. Am J Physiol Gastrointest Liver Physiol. 2006 Oct;291(4):G658-65. doi: 10.1152/ajpgi.00585.2005. Epub 2006 Feb 23. PMID: 16500917.
6. Holzer P. Capsaicin: cellular targets, mechanisms of action, and selectivity for thin sensory neurons. Pharmacol Rev. 1991 Jun;43(2):143-201. PMID: 1852779.
7. Giuliani S, Lecci A, Tramontana M, Maggi CA. Nociceptin protects capsaicin-sensitive afferent fibers in the rat urinary bladder from desensitization. Naunyn Schmiedebergs Arch Pharmacol. 1999 Aug;360(2):202-8. doi: 10.1007/s002109900047. PMID: 10494891.
8. Cruz F. Desensitization of bladder sensory fibers by intravesical capsaicin or capsaicin analogs. A new strategy for treatment of urge incontinence in patients with spinal detrusor hyperreflexia or bladder hypersensitivity disorders. Int Urogynecol J Pelvic Floor Dysfunct. 1998;9(4):214-20. doi: 10.1007/BF01901607. PMID: 9795827.
9. Bapir R, Bhatti KH, Eliwa A, García-Perdomo HA, Gherabi N, Hennessey D, Magri V, Mourmouris P, Ouattara A, Perletti G, Philipraj J, Stamatiou K, Trinchieri A, Buchholz N. Efficacy of overactive neurogenic bladder treatment: A systematic review of randomized controlled trials. Arch Ital Urol Androl. 2022 Dec 28;94(4):492-506. doi: 10.4081/aiua.2022.4.492. PMID: 36576454.
10. Yu PH, Wang CC. Adverse Effects of Intravesical OnabotulinumtoxinA Injection in Patients with Idiopathic Overactive Bladder or Neurogenic Detrusor Overactivity: A Systematic Review and Meta-Analysis of Randomized Controlled Studies. Toxins (Basel). 2024 Aug 5;16(8):343. doi: 10.3390/toxins16080343. PMID: 39195753; PMCID: PMC11359369.
11. Kuo HC. Botulinum Toxin Paves the Way for the Treatment of Functional Lower Urinary Tract Dysfunction. Toxins (Basel). 2020 Jun 14;12(6):394. doi: 10.3390/toxins12060394. PMID: 32545870; PMCID: PMC7354673.
12. Panunzio A, Tafuri A, Mazzucato G, Cerrato C, Orlando R, Pagliarulo V, Antonelli A, Cerruto MA. Botulinum Toxin-A Injection in Chronic Pelvic Pain Syndrome Treatment: A Systematic Review and Pooled Meta-Analysis. Toxins (Basel). 2022 Jan 1;14(1):25. doi: 10.3390/toxins14010025. PMID: 35051002; PMCID: PMC8780260.
13. Nitti V, Haag-Molkenteller C, Kennelly M, Chancellor M, Jenkins B, Schurch B. Treatment of neurogenic detrusor overactivity and overactive bladder with Botox (onabotulinumtoxinA): Development, insights, and impact. Medicine (Baltimore). 2023 Jul 1;102(S1):e32377.
doi: 10.1097/MD.0000000000032377. PMID: 37499088; PMCID: PMC10374192.
14. de Sèze M, Wiart L, Ferrière J, de Sèze MP, Joseph P, Barat M. Intravesical instillation of capsaicin in urology: A review of the literature. Eur Urol. 1999 Oct;36(4):267-77. doi: 10.1159/000020004. PMID: 10473984.
15. Juszczak K, Thor PJ. The basic neurophysiologic concept of lower urinary tract function--the role of vanilloid TRPV1 receptors of urinary bladder afferent nerve endings. Adv Clin Exp Med. 2012 Jul-Aug;21(4):417-21. PMID: 23240446.
16. Holzer P, Izzo AA. The pharmacology of TRP channels. Br J Pharmacol. 2014 May;171(10):2469-73. doi: 10.1111/bph.12723. PMID: 24773265; PMCID: PMC4008994.
17. Abdel-Salam OME, Mózsik G. Capsaicin, The Vanilloid Receptor TRPV1 Agonist in Neuroprotection: Mechanisms Involved and Significance. Neurochem Res. 2023 Nov;48(11):3296-3315. doi: 10.1007/s11064-023-03983-z. Epub 2023 Jul 26. PMID: 37493882; PMCID: PMC10514110.
18. Ramos-Lopez O, Martinez-Aceviz Y, Sobrevilla-Navarro AA, Chavez-Mendez JR. Genetic Influence on Capsaicin Tolerance: Precision Nutrition Implications for Obesity Handling. Lifestyle Genom. 2024;17(1):57-63. doi: 10.1159/000539293. Epub 2024 May 29. PMID: 38810602.
19. Lepiarczyk E, Maździarz M, Paukszto Ł, Bossowska A, Majewski M, Kaleczyc J, Łopieńska-Biernat E, Jaśkiewicz Ł, Skowrońska A, Skowroński MT, Majewska M. Transcriptomic Characterization of the Porcine Urinary Bladder Trigone Following Intravesical Administration of Resiniferatoxin: Insights from High-Throughput Sequencing. Toxins (Basel). 2025 Mar 9;17(3):127. doi: 10.3390/toxins17030127. PMID: 40137900; PMCID: PMC11946646.
20. Szallasi A. Resiniferatoxin: Nature's Precision Medicine to Silence TRPV1-Positive Afferents. Int J Mol Sci. 2023 Oct 10;24(20):15042. doi: 10.3390/ijms242015042. PMID: 37894723; PMCID: PMC10606200.
21. Birder L, Andersson KE. Urothelial signaling. Physiol Rev. 2013 Apr;93(2):653-80. doi: 10.1152/physrev.00030.2012. PMID: 23589830; PMCID: PMC3768101.
22. Lazzeri M, Beneforti P, Turini D. Urodynamic effects of intravesical resiniferatoxin in humans: preliminary results in stable and unstable detrusor. J Urol. 1997 Dec;158(6):2093-6. doi: 10.1016/s0022-5347(01)68164-3. PMID: 9366319.
23. Hamid R, Averbeck MA, Chiang H, Garcia A, Al Mousa RT, Oh SJ, Patel A, Plata M, Del Popolo G. Epidemiology and pathophysiology of neurogenic bladder after spinal cord injury. World J Urol. 2018 Oct;36(10):1517-1527. doi: 10.1007/s00345-018-2301-z. Epub 2018 May 11. PMID: 29752515.
24. Shimizu N, Saito T, Wada N, Hashimoto M, Shimizu T, Kwon J, Cho KJ, Saito M, Karnup S, de Groat WC, Yoshimura N. Molecular Mechanisms of Neurogenic Lower Urinary Tract Dysfunction after Spinal Cord Injury. Int J Mol Sci. 2023 Apr 26;24(9):7885. doi: 10.3390/ijms24097885. PMID: 37175592; PMCID: PMC10177842.
25. Birder LA, de Groat WC. Mechanisms of disease: involvement of the urothelium in bladder dysfunction. Nat Clin Pract Urol. 2007 Jan;4(1):46-54. doi: 10.1038/ncpuro0672. PMID: 17211425; PMCID: PMC3119256.
26. Chandiramani VA, Peterson T, Duthie GS, Fowler CJ. Urodynamic changes during therapeutic intravesical instillations of capsaicin. Br J Urol. 1996 Jun;77(6):792-7. doi: 10.1046/j.1464-410x.1996.09844.x. PMID: 8705210.
27. 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. 1998 Feb;159(2):567-70. doi: 10.1016/s0022-5347(01)63985-5. PMID: 9649293.