Perisphincteric Botox Injections

Adam Boyd · Post by **Adam Boyd** » Fri Jan 10, 2003 2:13 am

After UW hinted at Dr. Berger's success with Botox in their press release regarding the Allen Foundation grant, I ordered a copy of a paper on the use of Botox in CPPS from the October 2000 issue of European Urology from Karger Publishers. The paper is titled, Persiphinteric Injection of Botulinum Toxin Type A: A Treatment Option for Patients with Chronic Prostatic Pain?. The authors, Zermann, Ishigooka, Schubert, and Schmidt present their results of an uncontrolled pilot study of Botox injections to the external urethral sphincter in 11 CPPS patients. All patients exhibited urethral hypersensitivty as assessed by the patients' subjective responses to movement of a small catheter in the urethra. Interestingly, nine of the eleven patients (81.8%) experienced significant subjective pain relief, with an average reduction on a visual analog scale of better than 75% at a short term follow-up.

From the discussion section:

"Whether pelvic muscular dysfunction is a root cause of pain or an integral part of the CNS failure that underlies prostatic pain, addressing the muscular dysfunction directly makes sense. It is a logical step toward reducing the neurogenic cascade of events that can feed inflammation and hypersensitivity in tissue. "

Post by **webslave** » Fri Jan 10, 2003 5:22 pm

I know we'll all be watching this research very carefully.

Thanks for posting this.

chrishorseman · Post by **chrishorseman** » Tue Jan 28, 2003 2:58 pm

Was there more information in the version you ordered than in the brief at Medline

This short version had a happy ever after feel to it and life is never that simple.

Adam Boyd · Post by **Adam Boyd** » Thu Jan 30, 2003 12:53 am

Was there more information in the version you ordered than in the brief at Medline

I ordered the full text article for $26 (USD). It contained much more information than what was included in the abstract, but unfortunately, there was no information on any long-term follow-up of any of these patients. If you have any specific questions about the paper, I'd be happy to answer them for you.

Post by **webslave** » Tue Feb 04, 2003 2:30 am

Adam Boyd wrote:there was no information on any long-term follow-up of any of these patients.

Short followup, no placebo group, not blinded, not randomized etc, underpowered (small cohort) ... not much to build hope on yet.

Adam Boyd · Post by **Adam Boyd** » Fri Feb 07, 2003 1:10 am

Short followup, no placebo group, not blinded, not randomized etc, underpowered (small cohort) ... not much to build hope on yet.

You're right, this was a pilot study. These types of studies routinely precede larger randomized trials. Fortunately, Berger's study was placebo-controlled, and I'd suspect with the level of funding his lab receives it included more patients. If his results are as impressive as the results of this study (better than 75% pain reduction in more than 80% of patients), I think we'd all have something to be hopeful about.

Post by **webslave** » Fri Feb 07, 2003 1:46 am

Depends. I'm not too keen on regular, expensive injections in that area.

latte · Post by **latte** » Fri Feb 07, 2003 4:25 pm

Sounds like an intriguing option. Do any of you know how the injections are performed? Where do they put the needle?

Post by **webslave** » Fri Feb 07, 2003 7:07 pm

Read this
viewtopic.php?t=87

UCPPS - Prostatitis, Interstitial Cystitis Forum

UCPPS - Prostatitis, Interstitial Cystitis Forum

Perisphincteric Botox Injections

Perisphincteric Botox Injections

Botox injections