5.3.1. Electromotive Drug Administration

Electromotive drug administration (EMDA) was designed in 1996 to transfer drugs into the bladder submucosa area for treating bladder cancer [23]. The previous review mentioned that EMDA contained three phenomena: Iontophoresis, electro-osmosis, and electroporation. Iontophoresis passes an electrical current forming the active charged ingredient and propels a substance into tissues. Electro-osmosis transfers non-ionized polar molecules and ionized molecules against their coulombic gradients. And electroporation increases electrical conductivity and permeability of the cell plasma membranes [24]. In clinical trials, electromotive delivery of mitomycin has been used to treat non–muscle-invasive bladder cancer to reduce its recurrence rate [25,26]. A basic study also reported that EMDA systems could enhance mitomycin transport into the full-thickness of the bladder wall without chemical modification or without changing the histology of the urothelium, lamina propria, and muscularis [27]. Nowadays, some studies apply EMDA on improving local anesthesia effects and the treatment of detrusor overactivity and interstitial cystitis in patients. The drugs under EMDA delivery studies include lidocaine, mitomycin C, oxybutynin, verapamil, resiniferatoxin, and dexamethasone [28].

Researchers applied EMDA to transfer onaBoNTA into the bladder of children with myelomeningocele-associated neurogenic bladder. They instilled onaBoNTA solution into children's bladders and delivered 10 mA of pulsed currents for 15 or 20 min without anesthesia [29,30]. The results of these studies demonstrated that children with myelomeningocele-associated neurogenic bladder might benefit from this administration in terms of urinary incontinence and vesicoureteral reflux. Because these studies lacked a control group, the treatment benefit in other sensory disorders remains unclear.
