INTRODUCTION: Botulinum neurotoxin (BoNT) is probably the most potent biological 
toxin that can affect humans. Since its discovery by Justinus Kerner, BoNT has 
seen use in a wide range of cosmetic and non-cosmetic conditions such as 
cervical dystonia, cerebral palsy, migraines and hyperhidrosis. We tried to 
trace its history from its inception to its recent urological applications.
MATERIALS AND METHODS: Historical articles about botulinum toxin were reviewed 
and a Medline search was performed for its urological utility. We hereby present 
a brief review of historical aspects of BoNT and its applications in urology.
RESULTS: In 1793, the first known outbreak of botulism occurred due to 'spoiled' 
sausage in Wildebad, Germany. The German physician and poet Justinus Kerner 
published the first accurate description of the clinical symptoms of botulism 
(sausage poison). He was also the first to mention its potential therapeutic 
applications. In urology, BoNT has been used in bladder and urethral lesions 
with varying degree of success. Recently, BoNT applications were explained for 
prostatic disorders. BoNT applications in urology are in the treatment of 
detrusor external sphincter dyssynergia, detrusor overactivity, detrusor 
underactivity, spastic conditions of the urethral sphincter, chronic prostate 
pain, interstitial cystitis, non-fibrotic bladder outflow obstruction (including 
benign prostatic hyperplasia) and acute urinary retention in women.
CONCLUSION: Justinus Kerner is the godfather of botulism research. The role of 
BoNT in urology has evolved exponentially and it is widely used as an adjuvant 
in voiding dysfunction. In the future, its utility will broaden and guide the 
urologist in managing various urological disorders.