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 purified NTX for men with BPH. Ten male patients (mean age, 70.0 years) with BPH received 100 units (prostate volume [PV] ＜30 ml) or 200 units (PV >30 ml) of NTX injected into the prostate via a minimally invasive outpatient technique. Evaluation included uroflowmetry, postvoid residual urine volume (PVR), PV, and International Prostate Symptom Score (IPSS) measured at baseline and 1, 3, 6, and 12 months post-treatment. The status of 7 of the 10 patients examined was found to have improved within 1 month of treatment. The mean IPSS decreased from 23.8 ± 7.0 to 16.3 ± 10.3 (p＝0.0093) at 1 month, to 14.9 ± 8.2 (p＝0.0074) at 3 months, and to 16.9 ± 7.3 (p＝0.018) at 12 months. The mean PV decreased from 47.8 ± 21.2 to 39.2 ± 19.5 ml (p＝0.0076) at 3 months. The PVR improved at 3 and 6 months post-treatment. Intraprostatic NTX injection induces prostate shrinkage and is effective in men with BPH.
Department of Urology, Kawasaki Medical School, Kurashiki, Okayama, Japan. uroyoko@med.kawasaki-m.ac.jp
Teruhiko
T
Yokoyama
Yumiko
Y
Yamamoto
Tomonori
T
Suzuki
Keiji
K
Oguma
Atsushi
A
Nagai
D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D009498:Neurotoxins / Q000627:therapeutic use*; D009929:Organ Size / Q000187:drug effects; D011467:Prostate / Q000187:drug effects / Q000473:pathology*; D011470:Prostatic Hyperplasia / Q000188:drug therapy*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D009498:Neurotoxins; D019274:Botulinum Toxins, Type A