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Botox Treatment Aids Enlarged Prostate

New Option Promises Relief, Fewer Side Effects
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WebMD Health News

Aug. 4, 2003 -- For men with enlarged prostates, a shot of Botox may soon be just what the doctor orders.

A small study suggests that Botox may offer a new option for men suffering from severe symptoms of enlarged prostate. Doctors know it as benign prostatic hyperplasia or BPH. Men -- more than half of those in their 60s and 90% of those in their 80s -- know it as difficult and often painful urination.

Enlarged prostate is a benign condition. That means it's not prostate cancer. But severe cases can require surgery. And current drug treatments have side effects that include dizziness and erectile dysfunction.

Now there may be a new option. Giorgio Maria, MD, of University Hospital Agostino Gemelli in Rome, and colleagues treated 30 men with severe symptoms of enlarged prostate. Half of the men got Botox injections to the prostate. The other half got a harmless salt solution.

The men started out with a score of 23 on the 35-point BPH symptom index developed by the American Urological Association. A score of 20-35 is rated "severe." After two months, the men who got Botox had a symptom score of 8. That's the lowest score in the AUA index's "moderate" range. A score of 0-7 is rated "mild."

Symptoms weren't the only thing that shrank. The men's prostates became half as large, and their PSA levels -- a measure of cancer risk -- also dropped.

"[Botox] injected into the prostate seems to be a promising approach for the treatment of benign prostatic hyperplasia," Maria and colleagues conclude in the August issue of Urology. "It is safe, effective, and well tolerated."

In an editorial comment accompanying the study, Alexis E. Te, MD, of Weill Cornell Medical College in New York, says the results of the Italian study are promising. He notes that not all urinary problems result from enlarged prostates -- nor do all enlarged prostates cause urinary problems. And as Botox is approved only for cosmetic use in the U.S., Te says many safety issues remain to be resolved.

"[Botox] is still a neurotoxin with potential and significant life-threatening morbidities," he warns.

SOURCE: Urology, August 2003.

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