Introduction and Objectives
There are reports on prostate cells apoptosis following Botulinum toxin type A injections and 30% prostate volume reduction. Stoma compartment dominates in human prostate. Study was divided into clinical and in vitro part. Its aim was to investigate why intraprostatic botulinum toxin had no significant influence on prostate volume in patients suffering from urinary retention (UR).
Material and Methods
In the clinical part, 5 patients aged from 75 to 88, suffering from BPH and UR were treated. Patients were previously disqualified from surgery and had not passed trials without catheters (TWOC). Prostate volume ranged from 38 to 104 ml. Botulinum toxin injection were performed under sonographic guidance (ProFocus, B&K, Denmark). Each lobe of adenoma was injected with 100 U Botox (Allergan, US) dissolved in 4 ml saline. Prostate volume and TWOC were performed after 6 months. In the in vitro part, 3T3 mouse fibroblasts and fibroblasts isolated from human prostate (material from adenomectomy) were cultured in presence of Botox (10, 5 and 1 U/ml) for 24 and 72 h. Cells were detached and counted in Neubauer chamber using trypan blue assay. Cells cultured in medium without botulinum toxin were the control group. Results were presented as means with standard deviations, p < 0.05 was considered statistically significant.
No early complications were observed. Prostate volume remained unchanged after six months and patients were unable to void. Number of 3T3 cells after 24 h incubation was 7.12+1.88, 7.12+0.64, 6.75+1.28 and 6.88+0.83×104, after 72 h 24.00+3.46, 22.75+3.73, 23.12+3.46 and 23.88+2.42×104, for 0, 1, 5 and 10 U/ml botulinum toxin type A concentrations respectively. Similarly, number of prostate fibroblasts was 7.50+1.20, 7.12+1.73, 6.50+1.93, and 6.25+1.58×104 after 24 h and 9.62+2.00, 9.12+1.55, 9.12+1.73 and 9.75+2.82×104 after 72 h.
Botox caused no improvement in UR nor prostate volume reduction and had no statistically significant, dose-dependent effect on neither 3T3 nor prostate fibroblasts proliferation.
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.