Quelle est la place de la toxine botulique dans le traitement de l’hyperplasie bénigne de prostate?

Botulinum toxin (BT) was first used in urology for the treatment of neuro-urological disorders such as bladder sphincter dyssynergia and incontinence due to neuropathic detrusor overactivity. Its action is now clearly demonstrated and it is now widely used in treating neurogenic neuropathic detrusor overactivity. May the botulinic toxin constitute an effective treatment for benign prostatic hyperplasia (BPH)? Intraprostatic BT injection has recently been investigated as a treatment for BPH. It appears that intraprostatic BT injection produced a statistically significant improvement in urinary symptoms with no significant side effects and may therefore represent an interesting minimally invasive alternative to conventional treatment of BPH. The benefits of using it are the simplicity of its implementation, the lack of reported side effects and a longer duration of action. Carefully conducted prospective, controlled studies on larger number of cases are now needed to confirm these early results. This study aims to assess the state of current knowledge of the mechanisms of action of BT in prostate disease and the results of major clinical trials for BPH.