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Review
. 2019 Oct 11;11(10):586.
doi: 10.3390/toxins11100586.

Promise and the Pharmacological Mechanism of Botulinum Toxin A in Chronic Prostatitis Syndrome

Chien-Hsu Chen  1 , Pradeep Tyagi  2 , Yao-Chi Chuang  3
Affiliations
Review

Promise and the Pharmacological Mechanism of Botulinum Toxin A in Chronic Prostatitis Syndrome

Chien-Hsu Chen et al. Toxins (Basel). .

Abstract

Chronic prostatitis/chronic pelvic pain syndrome (CP/ CPPS) has a negative impact on the quality of life, and its etiology still remains unknown. Although many treatment protocols have been evaluated in CP/CPPS, the outcomes have usually been disappointing. Botulinum neurotoxin A (BoNT-A), produced from Clostridium botulinum, has been widely used to lower urinary tract dysfunctions such as detrusor sphincter dyssynergia, refractory overactive bladder, interstitial cystitis/bladder pain syndromes, benign prostatic hyperplasia, and CP/ CPPS in urology. Here, we review the published evidence from animal models to clinical studies for inferring the mechanism of action underlying the therapeutic efficacy of BoNT in CP/CPPS. Animal studies demonstrated that BoNT-A, a potent inhibitor of neuroexocytosis, impacts the release of sensory neurotransmitters and inflammatory mediators. This pharmacological action of BoNT-A showed promise of relieving the pain of CP/CPPS in placebo-controlled and open-label BoNT-A and has the potential to serve as an adjunct treatment for achieving better treatment outcomes in CP/CPPS patients.

Keywords: Botulinum toxin; chronic prostatitis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Conceivable mechanisms of BoNT-A in the treatment of CP/CPPS.
Figure 2
Figure 2
The potential injection sites of BoNT-A for CP/CPPS treatment: intraprostatic, prostatic apex, external urethral sphincter, and pelvic floor muscles. (A) MRI, axial view (B) MRI, coronal view.
See this image and copyright information in PMC

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