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

• Type: Article in International Scientific Journal
• Date: 2008

Authors

João Fernando Alturas da Silva (Author) FMUP; Carlos Silva (Author) FMUP; Luís Saraiva (Author) FMUP; Andre Silva (Author) Other; Rui Pinto (Author) Other; Paulo Oliveira (Author) FMUP; Francisco Cruz (Author) FMUP

Journal

Title: European Urology

Vol. 53

Pages: 153-159

ISSN: 0302-2838

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 63 Citations

Scopus - 73 Citations

Pubmed / Medline

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

CORDIS: Health sciences > Medical sciences > Medicine > Urology ; Health sciences

Other information

Authenticus ID: P-004-37N

DOI: 10.1016/j.eururo.2007.08.050

Abstract (EN): Objectives: To evaluate the effect of intraprostatic injection of botulinum toxin A (BoNTA) on prostate volume and refractory urinary retention in patients with benign prostatic enlargement. Methods: Twenty-one men with benign prostatic enlargement on chronic indwelling catheter for at least 3 mo who were not candidates for surgery because of poor general condition received 200 U BoNTA in the transition zone by transrectal approach under ultrasound guidance. Patients were reevaluated at 1 and 3 mo posttreatment. Results: Patients had a mean age of 80 +/- 2 yr. Injections were done without anaesthetic support as an outpatient procedure. No significant local effects occurred. Baseline prostate volume of 70 +/- 10 ml decreased to 57 +/- 10 ml (p < 0.0006) at 1 mo and to 47 +/- 7 ml (p = 0.03 against 1 mo) at 3 mo. At 1 mo, 16 patients (76%) could resume voiding with a mean Q(max) of 9.0 +/- 1.2 ml/s. At 3 mo, 17 patients (81%) voided with a mean Q(max) of 10.3 +/- 1.4 ml/s. Residual urine was 80 +/- 19 ml and 92 +/- 24 ml at the two time points, respectively. Mean serum total PSA decreased from 6.0 +/- 1.1 ng/ml at baseline to 5.0 +/- 0.9 ng/ml at 3 mo (p = 0.04). Conclusions: BoNTA injection into the prostate swiftly reduces prostate volume and may be a promising treatment for refractory urinary retention in patients with benign prostatic enlargement who are unfit for surgery. Future studies will determine the duration of BoNTA effect.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 7