Duration of the Effects of a Single Intraprostatic Injection of Botulinum Toxin Type a in Frail Elderly Patients With Benign Prostatic Enlargement

Silva, João Figueira; Pinto, Rui; Botelho, Francisco; Oliveira, Rui; Carvalho, Thiago Augusto Cavalcante de; Silva, Carlos M.; Dinis, P.; Cruz, Francisco

doi:10.1016/s0022-5347(09)61823-1

Cited by 2 publications

(7 citation statements)

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“…All the studies in our review reported a fall in the IPSS score from the baseline levels, except Kuo,40 Silva et al,21, 22 Park et al,12 and Sreedar et al25 A statistically significant reduction was reported in 13 studies14, 16–20, 23, 24, 26, 36, 37, 41, 42 (54.1%) with a mean reduction of 10.8 ± 2.66 points. Maria18 reported that the reduction in the IPSS score was maintained after 12 months' follow‐up (8.9 + 3.2) P = 0.001 and McVary et al36 observed a fall of 37.4% in the IPSS scores after 12 months.…”

Section: Resultsmentioning

confidence: 67%

“…Maximum urinary flow also increased in all series, and the variation was statistically significant in 14 studies (58.3%), with a mean post‐treatment increase of 6.6 + 15.6 ml/sg 11, 14, 16–21, 23, 26, 36, 38, 41, 42. Maria et al18 reported a mean increase of 6.8 ml/sec after the first month of treatment ( P = 0.001), but for Park et al12 the increase was only significant after 3 months.…”

Section: Resultsmentioning

confidence: 81%

“…The reduction in prostate volume (PV) varied among the different series, and was statistically significant in 18 studies (75%), with a mean decrease of 22.43 + 20.2 cm 3 ,11, 12, 14, 16–23, 26, 36–39, 41, 42. McVary et al36 only observed a PV reduction until the third month of follow‐up and Nikoobakht et al20 reported PV reduction until month 12, while for Kuo and Liu,14 this improvement was maintained at 12 months ( P < 0.01).…”

Section: Resultsmentioning

confidence: 99%

“…The remaining studies were comprised of ten prospective cohorts,11, 16, 19, 20–23, 25, 37, 38 together with communications to congresses (presented subsequently in the supplements to their respective journals) 17, 24, 26, 34, 39, 40–42…”

Section: Methodsmentioning

confidence: 99%

“…Considering the different subtypes of botulinum toxin A, only Nikoobakht et al20, 42 used the subtype Abobotulinumtoxin A (Dysport, Ipsen Ltd, Berkshire, UK). Other authors, such as Chuang et al,11, 16, 23, 27 Park et al,12 Maria et al,18 Brisinda et al,19 Silva et al,21, 22, 41 Kuo and Liu,14 Kuo,37, 40 Jasinski et al,34 Karsenty et al,35 Agrawal et al,38 and Guercini et al39 used Onabotulinumtoxin A (Botox, Cosmetic, Allergan, Inc., Irvine, CA). However, many other authors do not communicate the subtype used in their works 13, 15, 17, 24–26, 36, 38…”

Section: Methodsmentioning

confidence: 99%

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The use of botulinum toxin in benign prostatic hyperplasia

Pérez

Herrera

et al. 2011

Neurourology and Urodynamics

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The injection of Botulinum toxin type A (BoNT/A) into the prostate is a minimally invasive alternative treatment for lower urinary tract symptoms. To summarize the action mechanisms of BoNT/A on experimental animals and to analyze its effectiveness according to published clinical studies, we located 24 papers on the treatment of HBP with BoNT/A. The doses applied ranged from 100 (OnabotA) to 600 U (OnabotA and AbobotA). The IPSS score presented a mean post-treatment reduction, for all series, of 10.8 + 2.66 points. Other significant results included the overall mean reduction in QoL score of 2.1 ± 0.62 points, and the pre and post-treatment differences in prostate volume (22.43 ± 20.2 cm(3)), post-voiding residue (76.77 + 51.72 cm(3)) and PSA (1.15 + 0.93 ng/ml). However, only two clinical trials were on sufficient quality to be selected for meta-analysis, and it was observed that the difference of the means, pre- and post-treatment of maximum flow, prostate volume, IPSS and PSA were not statistically significant (P = 0.18). Neither was there any statistically significant difference between pre- and post-treatment post-voiding residue (P = 0.65). In conclusion, BoNT/A alleviates lower urinary tract symptoms due to HBP, but different studies present considerable variations regarding the dose administered, inclusion criteria and follow-up time, as well as poorly defined retreatment, losses to follow up and, above all, a high degree of variability in the communication of results (with large standard deviations). In consequence, further clinical trials are needed.

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