Botulinum Toxin Injection for Prostate Disorders

Abstract

Benign prostatic hyperplasia (BPH) with its related symptoms is a common condition that affects nearly half of men over age 50 and 90% of men over the age of 80 (McVary 2006). Lower urinary tract symptoms caused by BPH which include nocturia, frequency, urgency, hesitancy, intermittency, and incomplete emptying can be very bothersome, affect an individual’s lifestyle significantly, and are costly (Wei et al. 2005). The condition is associated with a reduced quality of life and sleep disturbance. BPH may lead to urinary retention, bladder stones, renal insufficiency, and urinary tract infections. The anatomical location of the human prostate and the urethra lend itself to the development of lower urinary tract symptoms including both obstructive and irritative symptoms. The initial evaluation of BPH includes administration of a validated symptom index that evaluates the presence and severity of the main components of lower urinary tract symptoms. The importance of symptoms in the pathophysiology of BPH is underscored by the fact that symptom measurements comprised 78% of all endpoints from the recent Medical Treatment of Prostate Symptoms trial, compared to 22% of endpoints for objective measures such as urinary retention and urinary tract infection (Gormley et al. 2002). BPH, in a large part, is a neural phenomenon given that sensory symptoms such as frequency, urgency, and nocturia are key factors that push patients to seek treatment.