Intraprostatic Botulinum Toxin Type A Injection in Patients Unfit for Surgery Presenting with Refractory Urinary Retention and Benign Prostatic Enlargement. Effect on Prostate Volume and Micturition Resumption

Silva, João; Silva, Carlos; Saraiva, Luiz Alex Silva; Silva, André; Pinto, Rui; Dinis, Paulo; Cruz, Francisco

doi:10.1016/j.eururo.2007.08.050

Cited by 72 publications

(68 citation statements)

References 28 publications

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“…BTXA injections into the trigone to treat idiopathic OAB do not induce vesicoureteral reflux [355]. Intraprostatic BTXA injections reduce prostate volume and thereby contribute to the recovery of spontaneous micturition in patients with chronic urinary retention [613].…”

Section: Botulinum Toxin and Atp Releasementioning

confidence: 99%

Purinergic signalling in the urinary tract in health and disease

Burnstock

2013

Purinergic Signalling

140

149

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Purinergic signalling is involved in a number of physiological and pathophysiological activities in the lower urinary tract. In the bladder of laboratory animals there is parasympathetic excitatory cotransmission with the purinergic and cholinergic components being approximately equal, acting via P2X1 and muscarinic receptors, respectively. Purinergic mechanosensory transduction occurs where ATP, released from urothelial cells during distension of bladder and ureter, acts on P2X3 and P2X2/3 receptors on suburothelial sensory nerves to initiate the voiding reflex, via low threshold fibres, and nociception, via high threshold fibres. In human bladder t h e p u r i n e rg i c c o m p o n e n t o f p a r a s y m p a t h e t i c cotransmission is less than 3 %, but in pathological conditions, such as interstitial cystitis, obstructed and neuropathic bladder, the purinergic component is increased to 40 %. Other pathological conditions of the bladder have been shown to involve purinoceptor-mediated activities, including multiple sclerosis, ischaemia, diabetes, cancer and bacterial infections. In the ureter, P2X7 receptors have been implicated in inflammation and fibrosis. Purinergic therapeutic strategies are being explored that hopefully will be developed and bring benefit and relief to many patients with urinary tract disorders.

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Section: Botulinum Toxin and Atp Releasementioning

confidence: 99%

Purinergic signalling in the urinary tract in health and disease

Burnstock

2013

Purinergic Signalling

140

149

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“…However, the studies have shown no consistency in clinical response in terms of outcome parameters such as symptom scores (for example, the American Urological Association Symptom Index [AUASI] and the International Prostate Symptom Score [IPSS]), reduction in prostate volume, postvoid residual urine volume, peak urinary flow rate (Q max ) and PSA (Table 1). [62][63][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78][79] One intriguing finding is the observation that, even without a relevant impact on prostate volume in selected patients, the application of BoNT-A resulted in an increase in peak urinary flow rate and amelioration of LUTS. 65 This observation highlights the various pathophysiological aspects underlying LUTS suggestive of BPH.…”

Section: Mechanism Of Actionmentioning

confidence: 99%

New intraprostatic injectables and prostatic urethral lift for male LUTS

2015

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Treatment modalities for male lower urinary tract symptoms (LUTS) comprise a broad spectrum of medical and surgical options. Interest is growing in minimally invasive treatment options, which should ideally be performed in an outpatient setting and have a short recovery time, durable efficacy and a good safety profile. The preservation of all aspects of sexual function, including antegrade ejaculation, seems to be increasingly important for patients. Initial experimental data on new minimally invasive procedures-such as the intraprostatic injection of novel agents including botulinum neurotoxin A (BoNT-A), NX-1207 and PRX302-were promising, but clinical trials have not confirmed the findings. Trials of the mechanical prostatic urethral lift device-Urolift(®) (Neotract, Inc., USA)-have been positive, but further long-term results are needed to confirm its beneficial effects.

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“…21,22 The effectiveness of intraprostatic injections of steroids (betamethasone), different types of antibiotics (fluoroquinolones, aminoglycosides), and botulinum neurotoxin type A have been described in the literature. [17][18][19][20][21][22] However, due to the lack of randomized control trials, they are not routinely used in this route of administration. 1 There are no data in the literature on the use of intraprostatic drug injections in antimicrobial prophylaxis prior to TRUS-Bx.…”

Section: Discussionmentioning

confidence: 99%

“…[17][18][19][20] Apart from transrectal, also transperineal, transurethral, and even percutaneous suprapubic transvesical route have been used to deliver drugs directly to the prostate gland. 21,22 The effectiveness of intraprostatic injections of steroids (betamethasone), different types of antibiotics (fluoroquinolones, aminoglycosides), and botulinum neurotoxin type A have been described in the literature.…”

Section: Discussionmentioning

confidence: 99%