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Title

TRANSURETHRAL INJECTION OF BOTULINUM TOXIN IN BENIGN PROSTATIC HYPERPLASIA

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Abstract

 Introduction & Objective: BOTULINUM TOXIN is a presynaptic blocker of acetylcholine in neuromuscular junction and autonomic nerve endings. In recent years, in a few studies, transperineal injection of BOTULINUM TOXIN into the prostate has been used for treatment of urinary symptoms in men with BENIGN PROSTATIC HYPERPLASIA. We investigated the efficacy and safety of transurethral injection of BOTULINUM TOXIN into the prostate gland for the management of lower urinary tract symptom associated with BENIGN PROSTATIC HYPERPLASIA.Materials & Methods: After urethrocystoscopy under local anesthesia, BOTULINUM TOXIN, 100 units for each lobe were injected with a 3 centimeter 22 gauge needle. Prostate volume, post voiding residue, maximum flow rate, AUA Symptom scores, AUA Quality of life scores and serum PSA were measured before and after intervention at 1, 6 and 9 months follow up.Results: Fifteen patients with median age of 65 years were included in this study. After the primary intervention, all patients experienced partial improvement at 1-month follow up,; as demonstrated by 20% decrease in AUA Symptom Score and 25% decrease in QOL Score. Maximum flow rate increased 32%. Prostate volume and post voiding residue decreased 13% and 46% respectively. Serum PSA decreased 30%. Patients’ symptom scores remained at the same level after 6- and 9- month follow up, although maximum flow rate decreased 1.5 mL/ s at 9- month as compared with 6- month follow up.Conclusions: Transurethral injection of BOTULINUM TOXIN under local anesthesia is a safe, easy, and effective treatment for the management of symptoms of BENIGN PROSTATIC HYPERPLASIA.

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