Alam Marianne, Zgheib Joseph, Dalati Mohamad-Fadi, El Khoury Fouad
University of Balamand, St. George Hospital University Medical Center (SGHUMC), Beirut 1100 2807, Lebanon.
Collaborateur Scientifique d'Urologie, CHU St. Pierre, 1000 Brussels, Belgium.
Case Rep Urol. 2016;2016:6385276. doi: 10.1155/2016/6385276. Epub 2016 Mar 10.
Secondary to failure of optimal medical therapy and the high morbidity that accompanies surgical techniques in high risk patients, the use of de novo treatments including botulinum toxin A is emerging in the treatment of benign prostatic hyperplasia (BPH). However, the treatment of urinary retention secondary to BPH via injecting botulinum toxin into the bladder neck is not well established in the literature. This case report describes the case of a 75-year-old male patient with a chronic history of obstructive lower urinary tract symptoms (LUTS) and multiple comorbidities who was admitted to the hospital for management of recurrent urinary retention. The patient was not a surgical candidate for transurethral incision of the prostate (TUIP) or transurethral resection of the prostate (TURP). Botulinum toxin injection into the bladder neck was performed with very satisfying results. Botulinum toxin injection in the bladder neck presents a promising minimally invasive, tolerated, and cost-effective approach for the treatment of urinary retention in patients with benign prostatic obstruction who are not candidates for surgery or in whom medical treatment has failed. More research is needed to identify the efficacy of this novel approach.
由于最佳药物治疗失败以及高危患者手术技术伴随的高发病率，包括肉毒杆菌毒素A在内的新型治疗方法正在良性前列腺增生（BPH）的治疗中兴起。然而，通过向膀胱颈注射肉毒杆菌毒素治疗BPH继发的尿潴留，在文献中尚未得到充分确立。本病例报告描述了一位75岁男性患者的病例，该患者有慢性下尿路梗阻症状（LUTS）病史且合并多种疾病，因复发性尿潴留入院治疗。该患者不适合进行经尿道前列腺切开术（TUIP）或经尿道前列腺切除术（TURP）。向膀胱颈注射肉毒杆菌毒素取得了非常满意的效果。对于不适合手术或药物治疗失败的良性前列腺梗阻患者，膀胱颈注射肉毒杆菌毒素是一种有前景的微创、耐受性好且经济有效的尿潴留治疗方法。需要更多研究来确定这种新方法的疗效。
