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Hitting below the belt (Bladder): Botulinum treatment of urethral and prostate disorders

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Abstract

Botulinum toxin type A (BTX-A) has been used to treat urethral and prostatic diseases (off-label uses). Injection of BTX-A into the external sphincter of patients with detrusor external sphincter dyssynergia has been shown to successfully lower postvoid residual volumes and detrusor pressures. Average efficacy is 3 to 4 months, but long-term effects on detrusor leak point pressures or renal function are unknown. Injection of BTX-A into the prostate has shown promising shortterm results (≤ 12 months) in improving the symptoms, postvoid residual volumes, maximal urinary flow rates, and prostate sizes in patients with benign prostatic hyperplasia. The mechanisms of action and long-term durability of this treatment modality are unknown. Evidence supporting the use of BTX-A in treating detrusor hypocontractility, pelvic floor dysfunction, postpubovaginal sling retention, urethral stricture, prostatitis, and chronic pelvic pain syndrome in men is preliminary and deserves further evaluation.

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Authors and Affiliations

  1. Scott Department of Urology, Baylor College of Medicine, 6560 Fannin, Suite 2100, Houston, TX, 77030, USA

    Christopher P. Smith

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  1. H. Henry Lai
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Correspondence to Christopher P. Smith.

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Henry Lai, H., Smith, C.P. Hitting below the belt (Bladder): Botulinum treatment of urethral and prostate disorders. Curr Urol Rep 8, 351–358 (2007). https://doi.org/10.1007/s11934-007-0030-8

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  • DOI: https://doi.org/10.1007/s11934-007-0030-8

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