Chuang Yao-Chi, Tu Chieh-Hsien, Huang Chao-Cheng, Lin Hsin-Ju, Chiang Po-Hui, Yoshimura Naoki, Chancellor Michael B
Department of Urology, Chang Gung Memorial Hospital Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
BMC Urol. 2006 Apr 18;6:12. doi: 10.1186/1471-2490-6-12.
With the increasing interest with botulinum toxin--A (BTX-A) application in the lower urinary tract, we investigated the BTX-A effects on the canine prostate and also in men with bladder outlet obstruction (BOO) due to benign prostatic hyperplasia (BPH).
Transperineal injection into the prostate using transrectal ultrasound (TRUS) was performed throughout the study. Saline with or without 100 U of BTX-A was injected into mongrel dogs prostate. One or 3 months later, the prostate was harvested for morphologic and apoptotic study. In addition, eight BPH patients refractory to alpha-blockers were treated with ultrasound guided intraprostatic injection of 200 U of BTX-A.
In the BTX-A treated dogs, atrophy and diffuse apoptosis was observed with H&E stain and TUNEL stain at 1 and 3 months. Clinically, the mean prostate volume, symptom score, and quality of life index were significantly reduced by 18.8%, 73.1%, and 61.5% respectively. Maximal flow rate significantly increased by 72.0%.
Intraprostatic BTX-A injection induces prostate apotosis in dogs and relieves BOO in humans. It is therefore a promising alternative treatment for refractory BOO due to BPH.
随着肉毒杆菌毒素A（BTX-A）在下尿路应用方面的关注度不断提高，我们研究了BTX-A对犬前列腺以及对因良性前列腺增生（BPH）导致膀胱出口梗阻（BOO）的男性的影响。
在整个研究过程中，通过经直肠超声（TRUS）进行经会阴前列腺注射。将含有或不含100单位BTX-A的盐水注入杂种犬前列腺。1或3个月后，取出前列腺进行形态学和凋亡研究。此外，对8名对α受体阻滞剂难治的BPH患者进行超声引导下经前列腺注射200单位BTX-A治疗。
在接受BTX-A治疗的犬中，在1个月和3个月时，苏木精-伊红染色（H&E）和末端脱氧核苷酸转移酶介导的缺口末端标记法（TUNEL）染色观察到萎缩和弥漫性凋亡。临床上，平均前列腺体积、症状评分和生活质量指数分别显著降低了18.8%、73.1%和61.5%。最大尿流率显著增加了72.0%。
经前列腺注射BTX-A可诱导犬前列腺凋亡并缓解人类的BOO。因此，它是治疗因BPH导致的难治性BOO的一种有前景的替代疗法。
