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Volume 16, Issue 1 (January 2022)
IJT 2022, 16(1): 9-16 |
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Tavakkoli M, Ghorbani H, Nobahar A, Emadzadeh M, Aghaee A, Mottaghi M et al . Transurethral Intraprostatic Botulinum Toxin-a Injection in Patients with Benign Prostatic Hyperplasia: A Case Series and Literature Review. IJT 2022; 16 (1) :9-16
URL: http://ijt.arakmu.ac.ir/article-1-1004-en.html
URL: http://ijt.arakmu.ac.ir/article-1-1004-en.html
Mahmoud Tavakkoli1 
, Hamidreza Ghorbani1 , Amin Nobahar1 , Maryam Emadzadeh2 , Atena Aghaee3 , Mahdi Mottaghi1 , Salman Soltani * 4
, Hamidreza Ghorbani1 , Amin Nobahar1 , Maryam Emadzadeh2 , Atena Aghaee3 , Mahdi Mottaghi1 , Salman Soltani * 4
1- Department of Urology, Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
2- Clinical Research Development Unit, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
3- Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
4- Department of Urology, Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. , soltanis@mums.ac.ir
2- Clinical Research Development Unit, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
3- Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
4- Department of Urology, Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. , soltanis@mums.ac.ir
Abstract: (1605 Views)
Background: We aimed to assess the efficacy of Intraprostatic Onabotulinumtoxin-A (BTA) on the International Prostate Symptom Score (IPSS) and other objective measures of patients with Benign Prostatic Hyperplasia (BPH).
Methods: Fifteen patients were included in this study. The drug (BTA; 150 IU) was reconstituted in 20 mL of 0.9% saline before administration to the patients. After providing urethral anesthesia, 20 intraurethral injections were made to lateral lobes of the prostate, 10 injections in each lobe. Follow-up visits were planned 3 and 12 months after the intervention. Pre- and post-interventional IPSS, Prostate-Specific Antigen (PSA), Prostate Volume (PV), Post-Void Residue (PVR), and maximum urinary flow rate (Qmax) compared via paired t-test. Finally, we reviewed the Pubmed database to provide a more precise conclusion.
Results: The Mean±SD age of patients was 69±8.24 years, and the mean IPSS score decreased significantly from 24.3±3.3 to 14.6±3.7 (p<0.001) and 16.86±3.06 (p<0.009) on the 3rd and 12th months, respectively. The Mean±SD PSA, PVR, Qmax, and PV were 3.26±1.38, 82.33±35.55, 8.56±1.76, and 47.86±8.93, respectively at baseline. These factors significantly improved to 2.72±1.33 (P<0.000), 71.33±30.55 (p<0.000), 9.5±1.33 (p<0.011), and 42.86± 6.04 (p<0.000), respectively, on the 12th month follow-up.
Conclusion: Although the overall results support the efficacy of BTA for BPH, the best route of administration, the most effective dose, the optimal number, and the volume of injections need further investigations. The probable placebo effect and underlying medical conditions (e.g., insulin resistance) should be considered as the confounding factors.
Methods: Fifteen patients were included in this study. The drug (BTA; 150 IU) was reconstituted in 20 mL of 0.9% saline before administration to the patients. After providing urethral anesthesia, 20 intraurethral injections were made to lateral lobes of the prostate, 10 injections in each lobe. Follow-up visits were planned 3 and 12 months after the intervention. Pre- and post-interventional IPSS, Prostate-Specific Antigen (PSA), Prostate Volume (PV), Post-Void Residue (PVR), and maximum urinary flow rate (Qmax) compared via paired t-test. Finally, we reviewed the Pubmed database to provide a more precise conclusion.
Results: The Mean±SD age of patients was 69±8.24 years, and the mean IPSS score decreased significantly from 24.3±3.3 to 14.6±3.7 (p<0.001) and 16.86±3.06 (p<0.009) on the 3rd and 12th months, respectively. The Mean±SD PSA, PVR, Qmax, and PV were 3.26±1.38, 82.33±35.55, 8.56±1.76, and 47.86±8.93, respectively at baseline. These factors significantly improved to 2.72±1.33 (P<0.000), 71.33±30.55 (p<0.000), 9.5±1.33 (p<0.011), and 42.86± 6.04 (p<0.000), respectively, on the 12th month follow-up.
Conclusion: Although the overall results support the efficacy of BTA for BPH, the best route of administration, the most effective dose, the optimal number, and the volume of injections need further investigations. The probable placebo effect and underlying medical conditions (e.g., insulin resistance) should be considered as the confounding factors.
Keywords: Benign prostatic hyperplasia, Benign prostatic hypertrophy, Botox, Onabotulinumtoxin-A, Botulinum toxin A
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The Iranian Journal of Toxicology
Arak University of Medical Sciences in collaboration with the Iranian Society of Toxicology
Website: http://ijt.arakmu.ac.ir
Email: tox.journal@gmail.com
