Arnouk René, Suzuki Bellucci Carlos Henrique, Benatuil Stull Roberto, de Bessa José, Malave Cesar Augusto, Mendes Gomes Cristiano
Department of Urology, Dr. Carlos Arvelo Military Hospital, 1060 Caracas, Miranda, Venezuela.
ScientificWorldJournal. 2012;2012:463574. doi: 10.1100/2012/463574. Epub 2012 Sep 10.
To assess the efficacy and safety of intraprostatic injection of two botulinum neurotoxin type A (BoNT-A) doses for the treatment of benign prostatic hyperplasia (BPH).
Men with symptomatic BPH who failed medical treatment were randomized to receive 100 U or 200 U of BoNT-A into the prostate. The International Prostatic Symptom Score (IPSS), maximum flow rate (Q(max)), post-void residual volume (PVR), PSA levels and prostate volume before injection and after 3 and 6 months were evaluated. Adverse events were compared between the groups.
Thirty four patients were evaluated, including 17 in the BoNT-A 100 U group and 17 in the BoNT-A 200 U group. Baseline characteristics were similar in both groups. Both doses produced significant improvements in IPSS, Q(max) and PVR after 3 and 6 months and both doses promoted comparable effects. Prostate volume was affected by 200 U BoNT-A injection only after 6 months of treatment. PSA levels were significantly affected in the 100 U group only after 6 months of treatment. In the 200 U group, PSA levels were significantly decreased after 3 and 6 months. The complication rate was similar in both groups.
Efficacy and safety of both BoNT-A doses are similar for BPH treatment in the short term followup.
评估前列腺内注射两种剂量的A型肉毒杆菌神经毒素（BoNT-A）治疗良性前列腺增生（BPH）的疗效和安全性。
药物治疗无效的有症状BPH男性患者被随机分为两组，分别接受100 U或200 U的BoNT-A前列腺内注射。评估注射前、3个月和6个月后的国际前列腺症状评分（IPSS）、最大尿流率（Q(max)）、残余尿量（PVR）、前列腺特异性抗原（PSA）水平和前列腺体积。比较两组的不良事件。
共评估了34例患者，其中BoNT-A 100 U组17例，BoNT-A 200 U组17例。两组的基线特征相似。两种剂量在3个月和六个月后均使IPSS、Q(max)和PVR显著改善，且两种剂量的效果相当。仅在治疗6个月后，200 U BoNT-A注射才会影响前列腺体积。仅在治疗6个月后，100 U组的PSA水平才受到显著影响。在200 U组中，3个月和6个月后PSA水平均显著降低。两组的并发症发生率相似。
在短期随访中，两种剂量的BoNT-A治疗BPH的疗效和安全性相似。
