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Hitting below the belt (bladder): botulinum treatment of urethral and prostate disorders.

Abstract
Botulinum toxin type A (BTX-A) has been used to treat urethral and prostatic diseases (off-label uses). Injection of BTX-A into the external sphincter of patients with detrusor external sphincter dyssynergia has been shown to successfully lower postvoid residual volumes and detrusor pressures. Average efficacy is 3 to 4 months, but long-term effects on detrusor leak point pressures or renal function are unknown. Injection of BTX-A into the prostate has shown promising short-term results (< or = 12 months) in improving the symptoms, postvoid residual volumes, maximal urinary flow rates, and prostate sizes in patients with benign prostatic hyperplasia. The mechanisms of action and long-term durability of this treatment modality are unknown. Evidence supporting the use of BTX-A in treating detrusor hypocontractility, pelvic floor dysfunction, postpubovaginal sling retention, urethral stricture, prostatitis, and chronic pelvic pain syndrome in men is preliminary and deserves further evaluation.
AuthorsH Henry Lai, Christopher P Smith
JournalCurrent urology reports (Curr Urol Rep) Vol. 8 Issue 5 Pg. 351-8 (Sep 2007) ISSN: 1534-6285 [Electronic] United States
PMID17880832 (Publication Type: Journal Article, Review)
Chemical References
  • Botulinum Toxins, Type A
Topics
  • Aged
  • Botulinum Toxins, Type A (therapeutic use)
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Humans
  • Injections, Intralesional
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Prognosis
  • Prostatic Diseases (diagnosis, drug therapy)
  • Risk Assessment
  • Severity of Illness Index
  • Treatment Outcome
  • Urethral Diseases (diagnosis, drug therapy)

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