Patient‐reported outcomes in men with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) treated with intraprostatic OnabotulinumtoxinA: 3‐month results of a prospective single‐armed cohort study

Sacco, Emilio; Bientinesi, Riccardo; Marangi, Francesco; Totaro, Angelo; D’Addessi, Alessandro; Racioppi, Marco; Pinto, Francesco; Vittori, Matteo; Bassi, Pierfrancesco

doi:10.1111/j.1464-410x.2012.11288.x

Cited by 35 publications

(24 citation statements)

References 41 publications

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“…61 In an independent study, 67% of patients were satisfied with treatment with 200 units of BoNTA after 3 months of treatment; unsurprisingly, a similar number (68%) judged the treatment to be effective. 63 Results of these pilot studies seem promising, although other studies have not consistently shown the same results. 64,65 Furthermore, results of a randomized, double blind, placebo controlled phase II trial, published in 2013, failed to indicate any significant improvements in either urinary symptom scores or prostate measures in patients with LUTS and BPH who were treated with either BoNTA or placebo.…”

Section: Bph and Male Lutsmentioning

confidence: 90%

Current and potential urological applications of botulinum toxin A

Jiang

Liao

2015

Nat Rev Urol

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Botulinum toxin subtype A (BoNT-A) is a potent neurotoxin that can selectively modulate neurotransmitter release from nerve endings, resulting in muscular paralysis. BoNT-A might also act on sensory nerves, and have an anti-inflammatory effect. In the first urological use of BoNT-A, injection into the urethral sphincters of patients with detrusor-sphincter dyssynergia resulted in a reduction of urethral resistance and improved voiding efficiency. Subsequently, intravesical BoNT-A injections have received regulatory approval for treatment of neurogenic detrusor overactivity owing to spinal cord lesions or multiple sclerosis, and idiopathic overactive bladder in adults. BoNT-A has also been widely used to treat patients with the off-label indications of neurogenic or non-neurogenic voiding dysfunction and male lower urinary tract symptoms owing to BPH and bladder-neck dysfunction. Other indications for which urologists have applied BoNT-A injections include interstitial cystitis/bladder pain syndrome, bladder oversensitivity and chronic pelvic pain syndrome. BoNT-A is currently delivered as an intravesical injection; however, use of liposome encapsulated formulations is also beginning to show some therapeutic potential.

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Section: Bph and Male Lutsmentioning

confidence: 90%

Current and potential urological applications of botulinum toxin A

Jiang

Liao

2015

Nat Rev Urol

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“…BoNT-A injection in smaller prostate glands caused a much lesser reduction in prostate volume, but a 15% reduction was still observed [32,36]. Independent of the extent of prostate volume reduction, improvements in LUTS and flow have been consistently reported [29][30][31][32][44][45][46][47][48][49][50][51][52][53], while a decrease in total serum PSA was observed in some studies [e.g. 30,45,51], but not in others [52].…”

Section: Botulinum Toxinmentioning

confidence: 90%

Treatment of lower urinary tract symptoms: Agents for intraprostatic injection

Andersson

2013

Scandinavian Journal of Urology

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When the currently available pharmacotherapeutic principles used for treatment of male lower urinary tract symptoms (LUTS) fail, transurethral resection of the prostate still remains the widely applied gold-standard therapy, since the majority of minimally invasive therapies have not achieved the same efficacy and/or lack an evidence base to support their routine use. Intraprostatic injection therapy, which probably is the oldest minimally invasive surgical treatment, has not been widely used, but recent reports of successful treatments with several new agents have renewed interest in this approach. Anhydrous ethanol still seems to be one of the most extensively studied injectables to date, but intraprostatic injection of botulinum toxin has received much recent attention, with regard to both its mechanism of action and efficacy. In addition, other agents such as NX-1207 and PRX302 have been reported to have promising effects. Injection therapy, using the transperineal, transrectal and transurethral routes for delivery of the active compounds, seems to be an effective minimally invasive surgical therapy for LUTS associated with benign prostatic hyperplasia (BPH). However, further studies on mechanisms of action of the novel agents used, and controlled clinical trials documenting their efficacy and side-effects (which are largely lacking), are needed before their place in the treatment of BPH/LUTS can be properly assessed.

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“…Published studies on Botox reported that 200 U of Botox reconstituted with normal saline to a volume of 20% of the total prostate volume is required for the injections into the transition zone and peripheral zone of the prostate gland and to avoid any penetration into the bladder [53]. Common adverse events such as hematuria, difficult urination, perineal pain and acute prostatis, is likely related to inadvertent penetration of the injection needles into the prostatic urethra and bladder neck [53][54][55].…”

Section: Benign Prostatic Hyperplasiamentioning

confidence: 96%

“…Animal studies showed that intraprostatic BoNT-A injections can induce selective denervation and subsequent apoptosis and atrophy of the prostate gland [52]. Prostatic injections of BoNT-A can be performed using transperineal, transrectal or transurethral routes [53][54][55]. Published studies on Botox reported that 200 U of Botox reconstituted with normal saline to a volume of 20% of the total prostate volume is required for the injections into the transition zone and peripheral zone of the prostate gland and to avoid any penetration into the bladder [53].…”

Section: Benign Prostatic Hyperplasiamentioning

confidence: 99%

Botulinum toxin in urology: a review of clinical potential in the treatment of urologic and sexual conditions

Chung

2014

Expert Opinion on Biological Therapy

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BoNT-A has received regulatory approval for use in neurogenic DO and overactive bladder, but its use remains unlicensed in other lower urinary tract conditions such as non-neurogenic lower urinary tract symptoms in men with benign prostatic hyperplasia, bladder pain syndrome and DSD. Published literature shows that BoNT can be effective in carefully selected patient groups, has minimal adverse event profile and is generally well tolerated by many patients. However, many questions remain unanswered and larger scale multi-institutional studies are required to determine the key factors in BoNT treatment success.

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Patient‐reported outcomes in men with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) treated with intraprostatic OnabotulinumtoxinA: 3‐month results of a prospective single‐armed cohort study

Cited by 35 publications

References 41 publications

Current and potential urological applications of botulinum toxin A

Current and potential urological applications of botulinum toxin A

Treatment of lower urinary tract symptoms: Agents for intraprostatic injection

Botulinum toxin in urology: a review of clinical potential in the treatment of urologic and sexual conditions

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