Use of intravesical capsaicin for urge urinary incontinence and irritative voiding syndromes

Intravesical capsaicin has been used in the management of selected patients with urge urinary incontinence throughout this decade, but the past 12 months has seen considerable interest in this and related compounds. It is no coincidence that during the same period the capsaicin receptor was cloned and named the vanilloid receptor subtype 1 and the European dual centre study of intravesical capsaicin reported that overall 80% of patients derived some clinical benefit. In spite of this, ultrapotent capsaicin analogues such as resiniferatoxin, which also interact with the vanilloid receptor subtype 1, are being studied. Preliminary reports of the potential advantages of intravesical resiniferatoxin are beginning to emerge, and in the future drugs that manipulate the vanilloid receptor may become universally important in the management of neurogenic overactive bladders.