Nikoobakht Mohammadreza, Daneshpajooh Azar, Ahmadi Hamed, Namdari Farshad, Rezaeidanesh Maedeh, Amini Shahab, Pourmand Gholamreza
Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Hassan-Abad Sq., Tehran, Iran.
Scand J Urol Nephrol. 2010 Apr;44(3):151-7. doi: 10.3109/00365591003649201.
To evaluate the effect of intraprostatic botulinum toxin type A (BoNTA, Dysport) injection on lower urinary tract symptoms, prostate-specific antigen (PSA), prostate volume (PV), peak urine flow rate (Q(max)) and postvoiding residue (PVR), and to evaluate the role of PV in the treatment outcome.
Seventy-two men with PSA < 4 ng/ml, International Prostate Symptom Score (IPSS) > or = 8, Q(max) < 12 ml/s and PV < 60 ml were enrolled. A total of 300-600 U Dysport was injected transperineally under transrectal ultrasound guidance. Initial IPSS, quality of life (QoL) score, Q(max) and PVR were compared with their measures at 1, 6 and 12 months after the injection. Initial PSA and PV were compared with their values after 6 months. Parameters were also compared between patients with PV < or = 30 ml and those with PV > 30 ml.
The mean age of participants was 63.5 years. At follow-up sessions, IPSS and QoL score were significantly decreased (p < 0.001). PVR reduced significantly and Q(max) increased considerably (p < 0.001). PSA and PV substantially decreased after 6 months (p < 0.001). No serious complications were reported. Similar to patients with larger prostates, IPSS and QoL score decreased statistically significantly after 12 months in those with PV < or = 30 ml; however, changes in PV, PSA, PVR and Q(max) did not persist during 12 months' follow-up.
The procedure is safe and efficacious and the results are comparable to previous experiences with Botox. It seems that the toxin efficacy depends directly on PV in prostates < 60 ml.
评估经前列腺注射A型肉毒杆菌毒素（BoNTA，丽舒妥）对下尿路症状、前列腺特异性抗原（PSA）、前列腺体积（PV）、最大尿流率（Q(max)）和残余尿量（PVR）的影响，并评估PV在治疗结果中的作用。
纳入72名PSA<4 ng/ml、国际前列腺症状评分（IPSS）≥8、Q(max)<12 ml/s且PV<60 ml的男性。在经直肠超声引导下经会阴注射300 - 600 U丽舒妥。将初始IPSS、生活质量（QoL）评分、Q(max)和PVR与其在注射后1、6和12个月时的测量值进行比较。将初始PSA和PV与其6个月后的数值进行比较。还对PV≤30 ml的患者和PV>30 ml的患者的各项参数进行了比较。
参与者的平均年龄为63.5岁。在随访期间，IPSS和QoL评分显著降低（p<0.001）。PVR显著降低，Q(max)显著增加（p<0.001）。6个月后PSA和PV大幅下降（p<0.001）。未报告严重并发症。与前列腺较大的患者类似，PV≤30 ml的患者在12个月后IPSS和QoL评分在统计学上显著降低；然而，PV、PSA、PVR和Q(max)的变化在12个月的随访期间未持续存在。
该操作安全有效，结果与先前使用保妥适的经验相当。对于<60 ml的前列腺，毒素疗效似乎直接取决于PV。
