Transurethral Intraprostatic Botulinum Toxin-a Injection in Patients with Benign Prostatic Hyperplasia: A Case Series and Literature Review

Message:
Article Type:
Research/Original Article (دارای رتبه معتبر)
Abstract:
Background

We aimed to assess the efficacy of Intraprostatic Onabotulinumtoxin-A (BTA) on the International Prostate Symptom Score (IPSS) and other objective measures of patients with Benign Prostatic Hyperplasia (BPH).

Methods

Fifteen patients were included in this study. The drug (BTA; 150 IU) was reconstituted in 20 mL of 0.9% saline before administration to the patients. After providing urethral anesthesia, 20 intraurethral injections were made to lateral lobes of the prostate, 10 injections in each lobe. Follow-up visits were planned 3 and 12 months after the intervention. Pre- and post-interventional IPSS, Prostate-Specific Antigen (PSA), Prostate Volume (PV), Post-Void Residue (PVR), and maximum urinary flow rate (Qmax) compared via paired t-test. Finally, we reviewed the Pubmed database to provide a more precise conclusion.

Results

The Mean±SD age of patients was 69±8.24 years, and the mean IPSS score decreased significantly from 24.3±3.3 to 14.6±3.7 (p<0.001) and 16.86±3.06 (p<0.009) on the 3rd and 12th months, respectively. The Mean±SD PSA, PVR, Qmax, and PV were 3.26±1.38, 82.33±35.55, 8.56±1.76, and 47.86±8.93, respectively at baseline. These factors significantly improved to 2.72±1.33 (P<0.000), 71.33±30.55 (p<0.000), 9.5±1.33 (p<0.011), and 42.86± 6.04 (p<0.000), respectively, on the 12th month follow-up.

Conclusion

Although the overall results support the efficacy of BTA for BPH, the best route of administration, the most effective dose, the optimal number, and the volume of injections need further investigations. The probable placebo effect and underlying medical conditions (e.g., insulin resistance) should be considered as the confounding factors.

Language:
English
Published:
Iranian Journal of Toxicology, Volume:16 Issue: 1, Jan 2022
Pages:
9 to 16
https://www.magiran.com/p2381112  
سامانه نویسندگان
  • Tavakkoli، Mahmoud
    Author (1)
    Tavakkoli, Mahmoud
    Associate Professor urology, Mashhad University of Medical Sciences, Mashhad, Iran
  • Ghorbani، Hamidreza
    Author (2)
    Ghorbani, Hamidreza
    Associate Professor urology, Mashhad University of Medical Sciences, Mashhad, Iran
  • Aghaee، Atena
    Author (5)
    Aghaee, Atena
    Assistant Professor nuclear medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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