Botulinum toxin: future developments

The proposed mechanisms of action of botulinum neurotoxin-A (BoNT-A) in the bladder provide new insights that might help to understand better the complex machinery of the bladder wall and the importance of the afferent signalling mechanisms. BoNT-A might thus become to be considered a small revolution in the understanding and treatment of bladder overactivity. However, substantially more clinical and basic scientific data are needed before we can truly claim to comprehend how it influences lower urinary tract function, or its role in managing urological problems.