Prostate botulinum a toxin injection - An alternative treatment for benign prostatic obstruction in poor surgical candidates
Prostate botulinum a toxin injection - An alternative treatment for benign prostatic obstruction in poor surgical candidates
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DOI：
10.1016/j.urology.2004.10.077
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发表时间：
2005-04-01
期刊：
影响因子：
2.1
通讯作者：
Kuo, HC
中科院分区：
文献类型：
--
作者：
Kuo, HC
目标.在一项前瞻性研究中，评估前列腺注射A型肉毒杆菌毒素对手术不良患者的有效性。良性前列腺增生（BPH）患者通常通过药物治疗或经尿道切除术成功治疗。然而，一些慢性尿潴留或大量残余尿量的BPH患者是较差的手术候选人或药物治疗失败的患者。10例BPH伴尿潴留或尿后残余尿量大的患者接受200 U A型肉毒毒素前列腺移行区注射。比较两组治疗前和治疗后的临床疗效和尿动力学指标。所有患者治疗后自发排尿均有改善。其中，8例疗效优良（80%），2例疗效改善。治疗后排尿压力和残余尿量均明显下降。治疗后前列腺总体积明显减小，最大流速明显增加。A型肉毒毒素的最大作用出现在治疗后1周左右，并在治疗后3个月和6个月保持不变。随访6 ~ 12个月（平均9个月），无尿潴留复发，所有患者排尿情况均保持治疗后状态。未发现不良反应。前列腺注射A型肉毒杆菌毒素是一种有效的替代治疗方法，对手术效果不佳或药物治疗失败的良性前列腺阻塞患者的不良反应最小。(c)2005年爱思唯尔公司
Objectives. To evaluate, in a prospective study, the effectiveness of prostate injection of botulinum A toxin in patients who were poor surgical candidates. Patients with benign prostatic hyperplasia (BPH) are usually successfully treated with medical treatment or transurethral resection. However, some patients with chronic urinary retention or a large postvoid residual urine volume due to BPH are poor surgical candidates or are patients in whom medical treatment has failed.Methods. Ten patients with BPH and urinary retention or a large postvoid residual urine volume received 200 U botulinum A toxin injection into the transition zone of the prostate. The clinical results and urodynamic parameters at baseline and after treatment were compared.Results. All patients had an improvement in spontaneous voiding after treatment. Of them, 8 had an excellent result (80%) and 2 had an improved result. Both voiding pressure and postvoid residual volume were significantly decreased after treatment. The total prostate volume was significantly reduced, and the maximal flow rate was significantly increased after treatment. The maximal effects of botulinum A toxin appeared at about 1 week and were maintained at 3 and 6 months after treatment. At 6 to 12 months (mean 9) of follow-up, no patient had had recurrence of urinary retention and the voiding condition in all patients remained at the post-treatment status. No adverse effect was noted.Conclusions. Prostate injection of botulinum A toxin is an effective alternative treatment with minimal adverse effects for patients with benign prostatic obstruction who are poor surgical candidates or in whom medical treatment has failed. (c) 2005 Elsevier Inc.