Botox, a non-surgical alternative for treating BPH induced symptoms

Egypt: Intraprostatic injection of botulinum toxin-A (Botox; BTX‐A) significantly improves benign prostatic hyperplasia (BPH)‐induced lower urinary tract symptoms (LUTS), according to a recent study published in the journal The Prostate. BTX‐A injection is minimally invasive and can be used as a non-surgical alternative treatment for BPH.

LUTS is a term used to describe a range of symptoms related to problems of the lower urinary tract (bladder, prostate and urethra. They include:

• Storage’ symptoms-like sudden or urgent need to urinate and increased the frequency of urination at night (nocturia).


• ‘Voiding’ symptoms -like weak urine stream or the inability to empty the bladder completely.

Lower urinary tract symptoms (LUTS) are more common in older men and are more often attributed to an enlarged prostate gland, otherwise known as BPH. The prostate gland surrounds the urethra, the tube that carries urine from the bladder out of the body. As the prostate gets bigger, it may squeeze or partly block the urethra. This often causes problems with urinating.

Ayman S. Moussa, Urology Department, Faculty of Medicine, Beni‐Suef University, Beni‐Suef, Egypt, and colleagues conducted the study to determine the factors that predict the outcome of intraprostatic injection of botox in the treatment of benign prostatic hyperplasia ‐induced lower urinary tract symptoms and to evaluate its efficacy and safety.

For the purpose, the researchers studied 45 Egyptian patients with BPH induced LUTS. The patients were treated with BTX-A injection after failing previous medical treatment or refusing surgical intervention (mean age, 64.4±6.6 years). They measured relevant clinical characteristics at baseline and at 2, 4, 8, and 12 weeks after injection.

Also Read: AUA Guideline for Surgical Management of Benign Prostatic Hyperplasia

Key findings of the study include:

• Mean baseline international prostate symptom score (IPSS) 24.06 decreased to 18.75 at 2 weeks and progressively decreased to 16.37 at 12 weeks.


• Mean maximum urinary flow rate (Q_max) increased from 9.08 to 10.44 mL/s at 2 weeks and 11.44 mL/s at 12 weeks.


• Patients reported no significant complications requiring medical treatment.


• Mean prostate volume decreased from 67.44 to 66.06 cc at 12 weeks.


• Mean postvoiding residual urine (PVR) decreased from 82.62 to 57.66 mL at 12 weeks.

Also Read: NICE approves New therapy for benign prostatic hyperplasia

"Intraprostatic injection of BTX‐A as modality treatment of LUTS/BPH significantly improve IPSS, Q _max, PVR, and decrease prostate volume. We can suspect better results with this line of treatment in patients with IPSS ≤ 22 and Q _max ≤ 10 mL/min and prostate volume ≤ 56.5cc," concluded the authors.

For detailed study log on to https://doi.org/10.1002/pros.23805