Document Detail

Intraprostatic botulinum toxin type A administration: evaluation of the effects on sexual function.
MedLine Citation:
PMID:  21105985     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: • To evaluate the consequences on male sexual function of intraprostatic injection of botulinum toxin type A (BoNT/A) as a treatment for benign prostatic hyperplasia (BPH). Although BoNT/A is effective in decreasing symptoms of BPH, neuronal impairment caused by the neurotoxin might affect emission/ejaculation. These aspects have not been evaluated before.
PATIENTS AND METHODS: • In all, 16 sexually active men aged >60 years with BPH/benign prostatic enlargement (BPE), International Prostate Symptom Score (IPSS) ≥8 and a maximum urinary flow rate (Q(max)) <15 mL/s refractory to standard medical therapy volunteered for the study. • Patients were injected transrectally, under ultrasonographic control, with 200 U of BoNT/A in the prostate. Evaluation was carried out at baseline and 1, 3 and 6 months post-treatment. Erectile function was evaluated using the International Index of Erectile Function - Short Form (IIEF-5) questionnaire. • Orgasmic/ejaculatory function and libido were evaluated using questions 9, 10, 11 and 12 of the IIEF - Long Form. Total testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and prolactin were also investigated.
RESULTS: • The mean age was 73 ± 6 years. The IIEF-5 score was 16.5 ± 6 at baseline, 15.7 ± 6 at 1 month, 16.6 ± 6 at 3 months and 15.7 ± 5 at 6 months (differences nonsignificant). • The score for ejaculatory/orgasmic function (questions 9 and 10) remained fairly constant from baseline to the sixth month, 8.3 ± 1.9 and 8 ± 2.1 respectively. • The sexual desire score (questions 11 and 12 of the IIEF) also remained little changed from baseline (5.9 ± 1.6) to month 6 (6.1 ± 2). Total serum testosterone, LH, FSH and prolactin did not change during the study.
CONCLUSIONS: • Intraprostatic injection of BoNT/A in patients with BPE does not impair erectile, orgasmic or ejaculatory functions and does not change libido. • The male hormonal profile is not altered by BoNT/A injection. This facilitates the acceptance of BoNT/A as a treatment for BPH/BPE lower urinary tract symptoms (LUTS) refractory to standard medical management.
João Silva; Rui Pinto; Tiago Carvalho; Francisco Botelho; Pedro Silva; Carlos Silva; Francisco Cruz; Paulo Dinis
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-11-24
Journal Detail:
Title:  BJU international     Volume:  107     ISSN:  1464-410X     ISO Abbreviation:  BJU Int.     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-31     Completed Date:  2011-08-01     Revised Date:  2012-10-09    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  1950-4     Citation Subset:  IM    
Copyright Information:
Department of Urology, Hospital S. João, Institute for Molecular and Cell Biology, Porto, Portugal.
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MeSH Terms
Botulinum Toxins, Type A / adverse effects,  therapeutic use*
Cohort Studies
Ejaculation / drug effects
Libido / drug effects
Neurotoxins / adverse effects,  therapeutic use*
Orgasm / drug effects
Penile Erection / drug effects
Prostatic Hyperplasia / drug therapy*
Sexual Behavior / drug effects*
Treatment Outcome
Reg. No./Substance:
0/Neurotoxins; EC Toxins, Type A
Comment In:
J Urol. 2012 Sep;188(3):907   [PMID:  22883794 ]
J Urol. 2012 Jun;187(6):2160-1   [PMID:  22579196 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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