Intraprostatic botulinum toxin type A administration: evaluation of the effects on sexual function

• Type: Article in International Scientific Journal
• Date: 2011

Authors

Joao Silva (Author) FMUP; Rui Pinto (Author) FMUP; Tiago Carvalho (Author) FMUP; Francisco Botelho (Author) FMUP; Pedro Silva (Author) Other; Carlos Silva (Author) FMUP; Francisco Cruz (Author) FMUP; Paulo Oliveira (Author) FMUP

Journal

Title: BJU International

Vol. 107 No. 12

Pages: 1950-1954

ISSN: 1464-4096

Publisher: Wiley-Blackwell

Indexing

ISI Web of Knowledge - 20 Citations

Scopus - 23 Citations

Pubmed / Medline

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

CORDIS: Health sciences > Medical sciences > Medicine > Urology

Other information

Authenticus ID: P-002-QX1

DOI: 10.1111/j.1464-410x.2010.09841.x

Abstract (EN): Level of Evidence 4 What's known on the subject? and What does the study add? Intraprostatic injection of botulinum toxin type A was shown to be effective in decreasing symptoms of BPH in several recent studies. However, the possible impairment of sexual function caused by the neurotoxin had never been investigated. This study shows that intraprostatic administration of botulinum toxin type A neither causes deterioration of sexual function (libido, orgasm, erectile function or ejaculation), nor alteration of serum testosterone levels. OBJECTIVE center dot To evaluate the consequences on male sexual function of intraprostatic injection of botulinum toxin type A (BoNT/A) as a treatment for benign prostatic hyperplasia (BPH). Although BoNT/A is effective in decreasing symptoms of BPH, neuronal impairment caused by the neurotoxin might affect emission/ejaculation. These aspects have not been evaluated before. PATIENTS AND METHODS center dot In all, 16 sexually active men aged > 60 years with BPH/benign prostatic enlargement (BPE), International Prostate Symptom Score (IPSS) >= 8 and a maximum urinary flow rate (Q(max)) < 15 mL/s refractory to standard medical therapy volunteered for the study. center dot Patients were injected transrectally, under ultrasonographic control, with 200 U of BoNT/A in the prostate. Evaluation was carried out at baseline and 1, 3 and 6 months post-treatment. Erectile function was evaluated using the International Index of Erectile Function - Short Form (IIEF-5) questionnaire. center dot Orgasmic/ejaculatory function and libido were evaluated using questions 9, 10, 11 and 12 of the IIEF - Long Form. Total testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and prolactin were also investigated. RESULTS center dot The mean age was 73 +/- 6 years. The IIEF-5 score was 16.5 +/- 6 at baseline, 15.7 +/- 6 at 1 month, 16.6 +/- 6 at 3 months and 15.7 +/- 5 at 6 months (differences nonsignificant). center dot The score for ejaculatory/orgasmic function (questions 9 and 10) remained fairly constant from baseline to the sixth month, 8.3 +/- 1.9 and 8 +/- 2.1 respectively. center dot The sexual desire score (questions 11 and 12 of the IIEF) also remained little changed from baseline (5.9 +/- 1.6) to month 6 (6.1 +/- 2). Total serum testosterone, LH, FSH and prolactin did not change during the study. CONCLUSIONS center dot Intraprostatic injection of BoNT/A in patients with BPE does not impair erectile, orgasmic or ejaculatory functions and does not change libido. center dot The male hormonal profile is not altered by BoNT/A injection. This facilitates the acceptance of BoNT/A as a treatment for BPH/BPE lower urinary tract symptoms (LUTS) refractory to standard medical management.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 5