[2006] [1436] BENEFICIAL EFFECTS OF UP TO ONE YEAR WITH INTRAPROSTATIC BOTULINUM TOXIN TYPE A INJECTION ON LUTS AND QUALITY OF LIFE IN BPH PATIENTS

Yao-Chi Chuang*, Po-Hui Chiang, Kaohsiung Hsien, Taiwan Republic of China; Naoki Yoshimura, Fermando DeMiguel, Michael B Chancellor, Pittsburgh, PA.

Introduction and Objective: To present a comprehensive experience with intraprostatic Botulinum toxin A (BTX-A) injection in patients with symptomatic benign prostatic hyperplasia (BPH) and to assess the efficacy on lower urinary tract symptoms (LUTS) and quality of life (QOL). Methods: 41 men (mean age 69.1±7.1 years) with an IPSS ≥8, cystoscopic bilobar hyperplasia, peak flow rate less than 12 mL/s and refractory to medical treatment were injected with BTX-A (Botox, Allergan Inc.) 100 U (N=21, for prostate volume less then 30 mL) or 200 U (N=20, for prostate volume greater than 30 mL) into the prostate transperineally under transrectal ultrasound guidance. The clinical effects were evaluated at baseline and after treatment. Results: No significant local or systemic side effects were observed in any of the patients. 31 out of 41 patients (75.6%) have more than 30% improvement on LUTS and QOL indices. 4 out of 5 patients (80%) with urinary retention for more than one month can void spontaneously from one week to 1 month after BTX-A injection. 12 out of 41 patients (29.2%) did not have change of prosate volume, however, 7 out of the 12 patients (58.3%) still have more than 30% improvement in maximal flow rate, LUTS, and QOL.[table1]
[table2]
Data present mean± S.E.
* P<0.05
Conclusions: BTX-A injected into the prostate is a safe and effective treatment for patients with symptomatic BPH with improvement up to one year in some patients. The mechanisms on relief of LUTS through intraprostatic BTX-A injection may not totally depend on the volume shrinkage. Further placebo-controlled study with histology and molecular biology evaluation is needed to prove the mechanism and confirm the beneficial effect of BTX-A in BPH.

Podium: BPH: Surgical Therapy & New Technology (I) (3:30 PM-5:30 PM)