title: Intraprostatic injection of botulinum toxin type-A relieves bladder outlet obstruction in human and induces prostate apoptosis in dogs.
abstract: BACKGROUND
  With the increasing interest with botulinum toxin--A (BTX-A) application in the lower urinary tract, we investigated the BTX-A effects on the canine prostate and also in men with bladder outlet obstruction (BOO) due to benign prostatic hyperplasia (BPH).
  
  
  METHODS
  Transperineal injection into the prostate using transrectal ultrasound (TRUS) was performed throughout the study. Saline with or without 100 U of BTX-A was injected into mongrel dogs prostate. One or 3 months later, the prostate was harvested for morphologic and apoptotic study. In addition, eight BPH patients refractory to alpha-blockers were treated with ultrasound guided intraprostatic injection of 200 U of BTX-A.
  
  
  RESULTS
  In the BTX-A treated dogs, atrophy and diffuse apoptosis was observed with H&E stain and TUNEL stain at 1 and 3 months. Clinically, the mean prostate volume, symptom score, and quality of life index were significantly reduced by 18.8%, 73.1%, and 61.5% respectively. Maximal flow rate significantly increased by 72.0%.
  
  
  CONCLUSIONS
  Intraprostatic BTX-A injection induces prostate apotosis in dogs and relieves BOO in humans. It is therefore a promising alternative treatment for refractory BOO due to BPH.
authors.affiliation: Department of Urology, Chang Gung Memorial Hospital Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan. chancellormb@Upmc.edu
authors.forename: Yao-Chi
authors.initials: YC
authors.lastname: Chuang
authors.forename: Chieh-Hsien
authors.initials: CH
authors.lastname: Tu
authors.forename: Chao-Cheng
authors.initials: CC
authors.lastname: Huang
authors.forename: Hsin-Ju
authors.initials: HJ
authors.lastname: Lin
authors.forename: Po-Hui
authors.initials: PH
authors.lastname: Chiang
authors.forename: Naoki
authors.initials: N
authors.lastname: Yoshimura
authors.forename: Michael B
authors.initials: MB
authors.lastname: Chancellor
mesh_terms: D000368:Aged; D000818:Animals; D017209:Apoptosis; D001284:Atrophy; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D004285:Dogs; D006801:Humans; D020287:In Situ Nick-End Labeling; D007267:Injections; D008297:Male; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D011467:Prostate / Q000187:drug effects* / Q000473:pathology; D011470:Prostatic Hyperplasia / Q000150:complications; D018084:Ultrasonography, Interventional; D001748:Urinary Bladder Neck Obstruction / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A