Bladder C-fiber desensitization induces a long-lasting improvement of BPH-associated storage LUTS: a pilot study.
OBJECTIVE
To evaluate the effect of bladder C-fiber desensitization on BPH-associated storage LUTS.


METHODS
Twelve patients with predominant BPH-associated storage LUTS gave written informed consent to enter the study. IPSS and QoL scores, micturition chart, uroflowmetry, cystometry and post-void residual (PVR) were obtained at baseline and at 1, 3 and 6 months after a single intravesical administration of 50 nM resiniferatoxin (RTX) solution.


RESULTS
Mean IPSS score decreased from 20.1 +/- 6.0 to 10.5 +/- 4.4 at 1 month (p = 0.0001), to 10.3 +/- 4.4 at 3 months (p = 0.00001) and to 9.8 +/- 5.7 at 6 months (p < 0.00001). Mean QoL score decreased from 4.5 +/- 1 to 2.5 +/- 1 at 1 month (p = 0.0001), to 2.3 +/- 1 at 3 months (p = 0.0004) and to 2.6 +/- 1.2 at 6 months (p = 0.0003). Mean urinary frequency decreased from 15.2 +/- 8.5 to 10.8 +/- 7.3 at 1 month (p = 0.0002), to 10.2 +/- 4.9 at 3 months (p = 0.002) and to 11.7 +/- 9.2 at 6 months (p = 0.005). Urge incontinence, which was present in six cases, disappeared in 4 patients and decreased to less than half in the other two. Mean first desire to void and maximal cystometric capacity increased significantly after RTX whereas uroflowmetry and PVR were not altered.


CONCLUSIONS
Intravesical desensitization of bladder C fibres with intravesical RTX might be useful in the treatment of patients with predominant BPH associated storage LUTS.
Dinis
Paulo
P
Department of Urology, Hospital São João, Alameda Hernani Monteiro, 4200 Porto, Portugal.
Silva
João
J
Ribeiro
Maria José
MJ
Avelino
António
A
Reis
Mário
M
Cruz
Francisco
F
D000368:Aged; D004224:Diterpenes / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D036421:Nerve Fibers, Unmyelinated / Q000187:drug effects*; D009498:Neurotoxins / Q000627:therapeutic use*; D010865:Pilot Projects; D011470:Prostatic Hyperplasia / Q000150:complications*; D001743:Urinary Bladder / Q000187:drug effects* / Q000294:innervation*; D014555:Urination Disorders / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D014563:Urodynamics
D004224:Diterpenes; D009498:Neurotoxins; C024353:resiniferatoxin