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Treating BPH with Botox: What the Research Shows So Far

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 While most people think of Botox (botulinum toxin type A) as a wrinkle remedy, it may play a significant role in the near future as an effective remedy for benign prostatic hyperplasia (BPH). 

It's not clear how Botox actually works in the prostate, but it appears that after it is injected, Botox may weaken certain muscles or block certain nerves. This, in turn, helps improve urine flow and decrease residual urine left in the bladder. 

At a recent American Urological Association (AUA) meeting, Kevin T. McVary, M.D., Professor of Urology at Northwestern University, reported the results of the small phase II MIST2 (Minimally Invasive Surgical Treatments) trial that treated 108 men with an AUA symptom score of 8 or greater (which indicated moderate to severe BPH) with Botox. The men were randomized to receive either 100 Units (53 men) or 300 Units (55 men) of Botox injected directly into the prostate. The results were impressive: 

• At three months, there was a 37% reduction in the AUA symptoms score (19.2 to 11.1).

• There was a 28% increase in maximum flow rate at 90 days.

• At 12 months, the AUA symptom score as 36% lower compared to the start of the trial.

• Flow rate increased 28% over the year compared to the start of the trial. 

While Botox relieved the symptoms of BPH, it had no affect on gland size. The prostate did not shrink. Moreover, upwards of 30% of the men had no response whatsoever to the Botox.  For those who did get a good response, Dr. McVary noted that they maintained that response. However, no one yet knows how long that positive response can be maintained. 

At this time, Botox is not approved by the Food and Drug Administration for treating lower urinary tract symptoms, but study of the drug's impact on resolving urinary complaints continues. Dr. McVary will soon lead another Botox trial, this time with about 300 men, some of whom will receive a placebo instead of the Botox. 

Posted in Enlarged Prostate on November 9, 2010


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