OBJECTIVE: To evaluate the effect of botulinumneurotoxin type-A (BoNT-A) on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) refractory to medical therapy.
MATERIALS AND METHODS: From November 2011 to January 2013, 60 men aged ≥18 years with CP/CPPS, NIH-CPSI symptom scale score ≥10 and pain subscale score ≥8, and refractory to 4 to 6 weeks medical therapy underwent transurethral intraprostatic injection of BoNT-A or normal saline (NS) in a prospective pilot double-blind randomized study. NIH-CPSI total and subscale scores, AUA-SS, VAS and (QoL) scores and frequencies of diurnal and nocturnal urination were evaluated and compared at baseline and 1,3 and 6 months after injection and also were compared between two groups.
RESULTS: 60 consecutive patients were randomized as BoNT-A or placebo group. In BoNT-A group at 1, 3 and 6-month evaluation compared to baseline values, NIH-CPSI total and subscale scores, AUA-SS, VAS and QoL scores along with frequencies of diurnal and nocturnal urinations had significantly improved (p< 0.05). In contrast, none of these values showed improvement in placebo group and were statistically different from the values in treatment group. Although the difference between two groups in AUA-SS and frequencies of nocturnal urination was not significant at 1st month follow-up, but repeated measure analysis showed significant improving change of each of these values over entire follow up period in BoNT-A group which the most prominent was related to pain subscale score decreasing 64.76%, 75.63%, and 79.97% at 1,3 and 6 months after treatment compared to baseline followed by VAS score decreasing 62.3%, 72.4% and 82.1%, respectively. Only 2 patients developed mild transient gross hematuria, which were managed conservatively.
CONCLUSIONS: Transurethral intraprostatic BoNT-A injection may be an effective therapeutic option in CP/CPPS patients by reducing pain and improving QoL.
Written by:
Falahatkar S, Shahab E, Gholamjani Moghaddam K, Kazemnezhad E. Are you the author?
Urology Research Center, School of Medicine, Guilan University of Medical Sciences.
Reference: BJU Int. 2014 Oct 13. Epub ahead of print.
doi: 10.1111/bju.12951
PubMed Abstract
PMID: 25307409