Treatment of Benign Prostatic Hyperplasia by Ultrasound-Guided Botulinum Toxin Type A Injection

Abstract

The objective of the study was to determine the efficacy of ultrasound-guided botulinum toxin type A (BTX-A) injection in the treatment of benign prostatic hyperplasia (BPH). In the 32 patients clinically diagnosed with BPH, 200 IU BTX-A was injected into five points at the lateral and middle lobes of the prostate under the guidance of ultrasound using a balloon dilatational device. The international prostate symptom score, quality of life score, maximum flow rate, post-void residual urine volume, prostate-specific antigen, and prostate volume were determined before treatment and at 1, 3, 6, and 12 months after treatment. All clinical symptoms and indicators were remarkably improved 1 month after the treatment and reached the optimal levels at 6 months post-treatment. This improvement of clinical parameters was maintained for a period of at least 1 year. Ultrasound-guided BTX-A injection was found to be safe and effective in the management of BPH.

Update on minimally invasive surgery and benign prostatic hyperplasia

“…All clinical symptoms and indicators (IPSS, QoL, Q max , post-void residual urine) improved at 1 month posttreatment, reached optimal levels 6 months posttreatment, and was durable at 12 months posttreatment. Therefore, in this study, ultrasound-guided BoNT-A injections were found to be safe and effective in the management of BPH [25] .…”

Transperineal intraprostatic injection of botulinum neurotoxin A vs transurethral resection of prostate for management of lower urinary tract symptoms secondary to benign prostate hyperplasia: A prospective randomised study

“…Similarly, Arnouk et al [30] detected a significant difference in serum PSA levels at 6 months after intraprostatic 100 U BoNT-A injection, and after 3 and 6 months after injection of BoNT-A 200 U. Also, Ding et al [31] detected remarkable improvement in LUTS/BPH at 1 month after injection, which reached optimal levels at 6 months and was maintained for ≥1 year Patients who had deterioration in IPSS at the 12month follow-up were re-evaluated for urodynamic parameters and using TRUS, and 10 patients in the BoNT-A group underwent TURP, thus, intraprostatic BoNT-A injection spared surgical intervention in 36 patients (78.3%) who were satisfied with their outcome and accepted to continue follow-up, and postponed surgery in the 10 patients who were unsatisfied by their BoNT-A injection outcome. Consistent with these figures, Rodrigues de Carvalho et al [32] reported that intraprostatic BoNT-A injection could be an option for treating LUTS/BPH refractory to medical treatment in poor surgical candidates, preventing surgery in~70% of patients with limited side-effects.…”

“…While, Arnouk et al [30] detected a time course-dose dependent effect of BoNT-A injection of 100 and 200 U BoNT-A, as both doses produced significant subjective and objective improvements, but PV did not change significantly with 100 U, but was significantly reduced at the 6-month evaluation with a dose of 200 U. Moreover, multiple recent studies have reported the efficacy and safety of 200 U BoNT-A injection [31][32][33]. Concerning outcomes, BoNT-A injection did favourably in comparison to TURP, as shown by the nonsignificant differences in subjective scores determined throughout follow-up between patients of both groups.…”

Lantox—The Chinese Botulinum Toxin Drug—Complete English Bibliography and Comprehensive Formalised Literature Review

“…As shown in Table 6 , one observational study [ 49 ] suggested the effect of LAN on benign prostate hyperplasia. The mechanism involved remains unclear.…”