N56 Is botulinum toxin type A intraprostatic injections effective in patients with urinary retention?

Jasiński, Miłosz; Drewa, Tomasz; Tyloch, Janusz; Wolski, Zbigniew

doi:10.1016/s1569-9056(09)74831-6

Cited by 5 publications

(11 citation statements)

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“…All the studies reported treatment effectiveness (see Table IV). Thus, a total of 719 patients were observed to present partial or total recovery, except in Jasinski's series,34 in which all patients (5) continued to present urinary retention following treatment. Kuo37 reported that 80% of patients with prior chronic urinary retention obtained spontaneous voiding after treatment, and that 20% presented improvement after 6 months.…”

Section: Resultsmentioning

confidence: 99%

“…Jasinski et al34 observed a significant reduction in rat fibroblasts (3T3) and human fibroblasts, after treatment in a culture medium with doses of 1–10 U/ml of Abobotulinum toxin, while Karsenty et al35 reported the growth inhibition of LNCaP and PCA3 cells in vitro and in vivo after the application of Abobotulinum toxin.…”

Section: Methodsmentioning

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%

“…There was no standard approach to the doses applied; some authors used 100 U in small‐volume prostates (30 cm 3 ),12, 23 while others, such as Jasinski et al34 and De Kort et al24 used the same dose without stratifying patients by prostate volume (see Table III). On the other hand, authors such as Carwford et al13 and McVary et al36 used 100 and 300 U in order to determine the most effective dose.…”

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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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

The use of botulinum toxin in benign prostatic hyperplasia

Pérez

Herrera

et al. 2011

Neurourology and Urodynamics

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Botulinum toxin type A injection for neurogenic detrusor overactivity: Clinical outcome in Japanese patients

et al. 2012

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Abbreviations & Acronyms AE = adverse events BoNTA = botulinum toxin type A CIC = clean intermittent catheterization E = emotions GH = general health perception IDO = idiopathic detrusor II = incontinence impact IIG = incontinence impact questionnaire KHQ = King's Health Questionnaire MCC = maximum cystometric capacity MS = multiple sclerosis NDO = neurogenic detrusor overactivity P/S = physical and social limitations QOL = quality of life RL = role limitations SCL = spinal cord lesions S/E = sleep/energy SM = severity measures SNAP = soluble N-ethylmaleimide-sensitive factor attachment protein SNARE = soluble N-ethylmaleimide-sensitive factor attachment protein receptor SS = symptom severity UDI = urinary distress inventory UI = urinary incontinence UTI = urinary tract infection Objectives: To report our experience with intravesical injection of botulinum toxin type A into the detrusor muscle of patients with neurogenic detrusor overactivity secondary to suprasacral spinal cord lesions or multiple sclerosis. Methods: Between January 2003 and March 2011, 11 patients (aged 23-75 years) were treated with 40 injections of botulinum toxin type A 300 U. The patients were followed up for 4, 8 and 12 weeks after treatment. The King's Health Questionnaire was administered and cystometric studies were carried out at baseline and 8 weeks after treatment. Results: A total of six women and five men were treated. Analysis of the King's Health Questionnaire showed a significant improvement in eight of the nine domain scores at 8 weeks from baseline. On cystometric studies, the mean maximum cystometric capacity increased significantly in all patients at 8 weeks from baseline (P < 0.001). Bladder compliance also increased significantly (P < 0.001). The number of urinary incontinence episodes per day improved significantly from baseline after injection (4 weeks, P < 0.001; 8 weeks, P < 0.001; 12 weeks, P < 0.001). Lack of efficacy appeared 7.15 Ϯ 3.4 months after treatment. Conclusions: Injection of botulinum toxin type A into the detrusor muscle of patients with neurogenic detrusor overactivity secondary to suprasacral spinal cord lesions or multiple sclerosis consistently improves bladder control and quality of life.

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Botulinum Toxin A Injection in the Bladder Neck: A Promising Treatment for Urinary Retention

Alam

Zgheib

Dalati³

et al. 2016

Case Reports in Urology

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Secondary to failure of optimal medical therapy and the high morbidity that accompanies surgical techniques in high risk patients, the use of de novo treatments including botulinum toxin A is emerging in the treatment of benign prostatic hyperplasia (BPH). However, the treatment of urinary retention secondary to BPH via injecting botulinum toxin into the bladder neck is not well established in the literature. This case report describes the case of a 75-year-old male patient with a chronic history of obstructive lower urinary tract symptoms (LUTS) and multiple comorbidities who was admitted to the hospital for management of recurrent urinary retention. The patient was not a surgical candidate for transurethral incision of the prostate (TUIP) or transurethral resection of the prostate (TURP). Botulinum toxin injection into the bladder neck was performed with very satisfying results. Botulinum toxin injection in the bladder neck presents a promising minimally invasive, tolerated, and cost-effective approach for the treatment of urinary retention in patients with benign prostatic obstruction who are not candidates for surgery or in whom medical treatment has failed. More research is needed to identify the efficacy of this novel approach.

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N56 Is botulinum toxin type A intraprostatic injections effective in patients with urinary retention?

Cited by 5 publications

References 0 publications

The use of botulinum toxin in benign prostatic hyperplasia

The use of botulinum toxin in benign prostatic hyperplasia

Botulinum toxin type A injection for neurogenic detrusor overactivity: Clinical outcome in Japanese patients

Botulinum Toxin A Injection in the Bladder Neck: A Promising Treatment for Urinary Retention

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