| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 3927702 | European Urology | 2008 | 7 Pages |
ObjectivesTo evaluate the effect of intraprostatic injection of botulinum toxin A (BoNTA) on prostate volume and refractory urinary retention in patients with benign prostatic enlargement.MethodsTwenty-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.ResultsPatients 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 Qmax of 9.0 ± 1.2 ml/s. At 3 mo, 17 patients (81%) voided with a mean Qmax 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).ConclusionsBoNTA 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.
