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Toxins 2016, 8(5), 126; doi:10.3390/toxins8050126

Intraprostatic Botulinum Neurotoxin Type A Injection for Benign Prostatic Hyperplasia—A Spotlight in Reality

1
Department of Urology, Linko Chang Gung Memorial Hospital, Taipei 24401, Taiwan
2
Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
3
College of Medicine, Chang Gung University, Taipei 24401, Taiwan
*
Author to whom correspondence should be addressed.
Academic Editors: Hann-Chorng Kuo and Flaminia Pavone
Received: 18 December 2015 / Revised: 19 April 2016 / Accepted: 20 April 2016 / Published: 26 April 2016
(This article belongs to the Special Issue Botulinum Toxin A on Lower Urinary Tract Dysfunction)
View Full-Text   |   Download PDF [216 KB, uploaded 26 April 2016]

Abstract

Botulinum toxin is a neurotoxin produced by the bacterium Clostridium botulinum. It inhibits the release of acetylcholine and other neurotransmitters from the nerve terminal. Botulinum toxin, specifically toxin type A (BoNT-A) has been used since the 1970s to reduce the muscular hypercontraction disorders. The application of BoNT-A in urology field started from intra-bladder injection for overactive bladder, which has been recognized as third line therapy in many countries. Since prostate gland as well as bladder is under the influence of autonomic innervation, theorectically, injection of BoNT-A into the prostate induces chemo-denervation and modulation of prostate function, and reduces lower urinary tract symptoms (LUTS). This article reviews the application of BoNT-A in patients with LUTS/ benign prostatic hyperplasia (BPH) from mechanisms of action to clinical results. BoNT-A has been shown to induce prostate apoptosis, downregulation of alpha 1A receptors, and reduce contractile function of prostate in animal studies. Open studies of intraprostate BoNT-A injection have demonstrated promising results of reducing LUTS and improvement of voiding function in human LUTS/BPH, however, intraprostatic BoNT-A injection did not perform better than the placebo group in recent publications of placebo controlled studies. We suggested that BoNT-A prostate injection might benefit selected population of BPH/LUTS, but it is unlikely to be an effective therapy for general population of male LUTS/BPH. View Full-Text
Keywords: botulinum toxin; prostate; lower urinary tract symptoms; benign prostatic hyperplasia botulinum toxin; prostate; lower urinary tract symptoms; benign prostatic hyperplasia
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Hsu, Y.-C.; Wang, H.-J.; Chuang, Y.-C. Intraprostatic Botulinum Neurotoxin Type A Injection for Benign Prostatic Hyperplasia—A Spotlight in Reality. Toxins 2016, 8, 126.

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