WebMD Medical News
Louise Chang, MD
May 24, 2007-- Botox, which has been smoothing wrinkles for years, may also
help relieve the bothersome urinary symptoms associated with an enlarged
prostate or bladder conditions, researchers report.
The news came out at this week’s annual meeting of the American Urological
Association in Anaheim, Calif.
For years, some urologists have used Botox off-label (meaning used for
conditions not approved for by the FDA), says Michael Chancellor, MD, professor
of urology and obstetrics and gynecology at the University of Pittsburgh and
one of the researchers involved in this week’s presentations. The percentage of
U.S. doctors using it currently is small, he says.
“I’ve used it since 1998 for both bladder problems and prostate problems,”
Chancellor tells WebMD.
For bladder problems such as overactive bladder, the Botox generally last
about six months, he says; for prostate-related bladder problems, about a year.
After a few weeks, Chancellor says, some patients can stop the medications
originally prescribed to relieve the bladder symptoms.
Injecting Botox into the prostate gland helped ease urinary symptoms for up
to a year, says Yao-Chi Chuang, MD, a urologist at Chang Gung Memorial Hospital
in Taiwan and researcher for the study presented Wednesday at the
Chuang, Chancellor and their team studied 37 men (average age 67) who did
not do well on the medications commonly prescribed to help relieve the urinary
problems associated with an enlarged prostate, a condition called benign
prostatic hyperplasia or BPH. The prostate gland surrounds the urine-carrying
tube or urethra. When it enlarges too much, as it tends to do with age, it can
constrict the urethra, and men report trouble emptying the bladder
Common symptoms of BPH include weak urine stream, leaking or dribbling,
feeling that the bladder hasn't emptied completely after voiding, and more
Using a needle about 6 inches long, Chuang’s team injected 100 units to 200
units of Botox into each side of the prostate surrounding the urethra.
The total amount injected depended on the size of the man’s prostate, he
When the men were evaluated before and after treatment, Chuang found that
73% of the men had more than a 30% improvement in symptoms. “Effects lasted six
to 12 months,” he says. “It’s very safe.”
Exactly how it works isn’t certain, Chuang says. “It probably relieves
smooth muscle contractions of the prostate [that can contribute to the bladder
problems], and inhibits the inflammatory process [that also plays a role],”
Chuang tells WebMD.
The toxin may also help relieve symptoms of overactive bladder, in which the
bladder wall muscle inappropriately contracts, causing the urge to urinate,
other researchers reported.
Daniel M. Schmid, MD, of the University Hospital Zurich, and his colleagues
injected 100 units of Botox into the bladder wall muscle of 180 men and women
with overactive bladder. Within two weeks, he reported, 87% had significant
improvement in symptoms, with urgency disappearing in 75% and incontinence in
Chuang’s Botox study was unfunded. Now, he is enrolling subjects in a study
that will assign some men with BPH symptoms to a Botox group and others to a
control group that will get placebo injections that dont contain Botox.
That study is funded by Allergan, the maker of Botox.
SOURCES: Annual meeting of the American Urological Association, Anaheim,
Calif., May 19-24, 2007. Michael Chancellor, MD, professor of urology and
obstetrics and gynecology, University of Pittsburgh School of Medicine. Yao-Chi
Chuang, MD, urologist, Chang Gung Memorial Hospital, Taiwan.
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