Transurethral Intraprostatic Botulinum Toxin-a Injection in Patients with Benign Prostatic Hyperplasia: A Case Series and Literature Review

Authors

  • Amin Nobahar Department of Urology, Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Atena Aghaee Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Hamidreza Ghorbani Department of Urology, Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Mahdi Mottaghi Department of Urology, Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Mahmoud Tavakkoli Department of Urology, Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Maryam Emadzadeh Clinical Research Development Unit, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Salman Soltani Department of Urology, Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Abstract:

Background: We aimed to assess the efficacy of Intraprostatic Onabotulinumtoxin-A (BTA) on the International Prostate Symptom Score (IPSS) and other objective measures of patients with Benign Prostatic Hyperplasia (BPH). Methods: Fifteen patients were included in this study. The drug (BTA; 150 IU) was reconstituted in 20 mL of 0.9% saline before administration to the patients. After providing urethral anesthesia, 20 intraurethral injections were made to lateral lobes of the prostate, 10 injections in each lobe. Follow-up visits were planned 3 and 12 months after the intervention. Pre- and post-interventional IPSS, Prostate-Specific Antigen (PSA), Prostate Volume (PV), Post-Void Residue (PVR), and maximum urinary flow rate (Qmax) compared via paired t-test. Finally, we reviewed the Pubmed database to provide a more precise conclusion. Results: The Mean±SD age of patients was 69±8.24 years, and the mean IPSS score decreased significantly from 24.3±3.3 to 14.6±3.7 (p<0.001) and 16.86±3.06 (p<0.009) on the 3rd and 12th months, respectively. The Mean±SD PSA, PVR, Qmax, and PV were 3.26±1.38, 82.33±35.55, 8.56±1.76, and 47.86±8.93, respectively at baseline. These factors significantly improved to 2.72±1.33 (P<0.000), 71.33±30.55 (p<0.000), 9.5±1.33 (p<0.011), and 42.86± 6.04 (p<0.000), respectively, on the 12th month follow-up. Conclusion: Although the overall results support the efficacy of BTA for BPH, the best route of administration, the most effective dose, the optimal number, and the volume of injections need further investigations. The probable placebo effect and underlying medical conditions (e.g., insulin resistance) should be considered as the confounding factors.  

Upgrade to premium to download articles

Sign up to access the full text

Already have an account?login

similar resources

Intraprostatic Botulinum Toxin injection in patients with benign prostatic enlargement

Histological evidence of benign prostatic hyperplasia (BPH) exceeded 50% in men over 50 years of age and rose to 75% as men entered the eighth decade. Therapeutic options for BPH generally fall into one of the three categories: watchful waiting, medical treatment and surgery. Excluding watchful waiting, the other forms of intervention directed at modifying the physiologic effects of BPH with or...

full text

Intraprostatic Botulinum Neurotoxin Type A Injection for Benign Prostatic Hyperplasia—A Spotlight in Reality

Botulinum toxin is a neurotoxin produced by the bacterium Clostridium botulinum. It inhibits the release of acetylcholine and other neurotransmitters from the nerve terminal. Botulinum toxin, specifically toxin type A (BoNT-A) has been used since the 1970s to reduce the muscular hypercontraction disorders. The application of BoNT-A in urology field started from intra-bladder injection for overa...

full text

Botulinum toxin and benign prostatic hyperplasia

Benign prostatic hyperplasia (BPH) is a clinical condition where lower urinary tract symptoms are caused by both a physically obstructing prostate as well as tight smooth muscles around the bladder outlet. Treatment of this condition with botulinum toxin has been used since 2003, but this interest has somewhat died down after two large randomized controlled trials (RCTs) showing equivalence of ...

full text

Intraprostatic Botulinum Toxin Type A injection in patients with benign prostatic enlargement: duration of the effect of a single treatment

BACKGROUND Botulinum Toxin Type-A (BoNT/A) intraprostatic injection can induce prostatic involution and improve LUTS and urinary flow in patients with Benign Prostatic Enlargement (BPE). However, the duration of these effects is unknown. The objective of this work was to determine the duration of prostate volume reduction after one single intraprostatic injection of 200U of Botulinum Toxin Type...

full text

Prostatic carcinoma shrunk after intraprostatic injection of botulinum toxin.

I performed a transperineal intraprostatic injection of botulinum toxin type A (BT-A) with a dosage of 1000 units of DysportTM/ Ipsen diluted in 0.5% adrenaline solution of water for injection, in a single injection directly between the two apparent hypoechoic areas under transrectal ultrasound (TRUS) guidance, in a total volume of 7 cm3, in order to relieve his ongoing prostatic obstruction. (...

full text

Intraprostatic botulinum neurotoxin type a injection for benign prostatic hyperplasia: preliminary results with a newly purified neurotoxin.

Several studies have demonstrated the efficacy of intraprostatic injection of botulinum neurotoxin type A (BoNT/A) against symptomatic benign prostatic hyperplasia (BPH). The most commonly used BoNT/A product, Botox(®), forms large complexes and composed of neurotoxin (NTX) as well as non-toxic components. We purified NTX lacking non-toxic components. We investigated the efficacy of this newly ...

full text

My Resources

Save resource for easier access later

Save to my library Already added to my library

{@ msg_add @}


Journal title

volume 16  issue 1

pages  9- 16

publication date 2022-01

By following a journal you will be notified via email when a new issue of this journal is published.

Keywords

Hosted on Doprax cloud platform doprax.com

copyright © 2015-2023