Yokoyama Teruhiko, Yamamoto Yumiko, Suzuki Tomonori, Oguma Keiji, Nagai Atsushi
Department of Urology, Kawasaki Medical School, Kurashiki, Okayama, Japan.
Acta Med Okayama. 2012;66(4):291-7. doi: 10.18926/AMO/48668.
Several studies have demonstrated the efficacy of intraprostatic injection of botulinum neurotoxin type A (BoNT/A) against symptomatic benign prostatic hyperplasia (BPH). The most commonly used BoNT/A product, Botox(®), forms large complexes and composed of neurotoxin (NTX) as well as non-toxic components. We purified NTX lacking non-toxic components. We investigated the efficacy of this newly purified NTX for men with BPH. Ten male patients (mean age, 70.0 years) with BPH received 100 units (prostate volume [PV] ＜30 ml) or 200 units (PV >30 ml) of NTX injected into the prostate via a minimally invasive outpatient technique. Evaluation included uroflowmetry, postvoid residual urine volume (PVR), PV, and International Prostate Symptom Score (IPSS) measured at baseline and 1, 3, 6, and 12 months post-treatment. The status of 7 of the 10 patients examined was found to have improved within 1 month of treatment. The mean IPSS decreased from 23.8 ± 7.0 to 16.3 ± 10.3 (p＝0.0093) at 1 month, to 14.9 ± 8.2 (p＝0.0074) at 3 months, and to 16.9 ± 7.3 (p＝0.018) at 12 months. The mean PV decreased from 47.8 ± 21.2 to 39.2 ± 19.5 ml (p＝0.0076) at 3 months. The PVR improved at 3 and 6 months post-treatment. Intraprostatic NTX injection induces prostate shrinkage and is effective in men with BPH.
多项研究已证实前列腺内注射A型肉毒杆菌神经毒素（BoNT/A）治疗有症状的良性前列腺增生（BPH）的疗效。最常用的BoNT/A产品保妥适（Botox®）形成大的复合物，由神经毒素（NTX）以及无毒成分组成。我们纯化了不含无毒成分的NTX。我们研究了这种新纯化的NTX对BPH男性患者的疗效。10例BPH男性患者（平均年龄70.0岁）通过微创门诊技术接受100单位（前列腺体积[PV]＜30 ml）或200单位（PV＞30 ml）的NTX注射入前列腺。评估包括在基线以及治疗后1、3、6和12个月测量尿流率、排尿后残余尿量（PVR）、PV和国际前列腺症状评分（IPSS）。在接受检查的10例患者中，有7例在治疗后1个月内病情有所改善。平均IPSS在1个月时从23.8±7.0降至16.3±10.3（p＝0.0093），在3个月时降至14.9±8.2（p＝0.0074），在12个月时降至16.9±7.3（p＝0.018）。平均PV在3个月时从47.8±21.2降至39.2±19.5 ml（p＝0.0076）。PVR在治疗后3个月和6个月有所改善。前列腺内注射NTX可导致前列腺缩小，对BPH男性患者有效。
