Dirk De Ridder led the review process.
Article first published online: 8 SEP 2011
Copyright © 2011 Wiley Periodicals, Inc.
Neurourology and Urodynamics
Volume 31, Issue 1, pages 86–92, January 2012
How to Cite
Marchal, C., Perez, J. E., Herrera, B., Machuca, F. J. and Redondo, M. (2012), The use of botulinum toxin in benign prostatic hyperplasia. Neurourol. Urodyn., 31: 86–92. doi: 10.1002/nau.21142
Conflict of interest: none.
- Issue published online: 23 JAN 2012
- Article first published online: 8 SEP 2011
- Manuscript Accepted: 22 MAR 2011
- Manuscript Received: 10 DEC 2010
- Fondo de Investigaciones Sanitarias (FIS) Spain. Grant Number: 09/910
- benign prostatic hyperplasia;
- botulinum toxin;
The injection of Botulinum toxin type A (BoNT/A) into the prostate is a minimally invasive alternative treatment for lower urinary tract symptoms. To summarize the action mechanisms of BoNT/A on experimental animals and to analyze its effectiveness according to published clinical studies, we located 24 papers on the treatment of HBP with BoNT/A. The doses applied ranged from 100 (OnabotA) to 600 U (OnabotA and AbobotA). The IPSS score presented a mean post-treatment reduction, for all series, of 10.8 + 2.66 points. Other significant results included the overall mean reduction in QoL score of 2.1 ± 0.62 points, and the pre and post-treatment differences in prostate volume (22.43 ± 20.2 cm3), post-voiding residue (76.77 + 51.72 cm3) and PSA (1.15 + 0.93 ng/ml). However, only two clinical trials were on sufficient quality to be selected for meta-analysis, and it was observed that the difference of the means, pre- and post-treatment of maximum flow, prostate volume, IPSS and PSA were not statistically significant (P = 0.18). Neither was there any statistically significant difference between pre- and post-treatment post-voiding residue (P = 0.65). In conclusion, BoNT/A alleviates lower urinary tract symptoms due to HBP, but different studies present considerable variations regarding the dose administered, inclusion criteria and follow-up time, as well as poorly defined retreatment, losses to follow up and, above all, a high degree of variability in the communication of results (with large standard deviations). In consequence, further clinical trials are needed. Neurourol. Urodynam. 31:86–92, 2012. © 2011 Wiley Periodicals, Inc.