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Titolo:
Perisphincteric injection of botulinum toxin type A - A treatment option for patients with chronic prostatic pain?
Autore:
Zermann, DH; Ishigooka, M; Schubert, J; Schmidt, RA;
Indirizzi:
Univ Jena Hosp, Dept Urol, D-07740 Jena, Germany Univ Jena Hosp Jena Germany D-07740 sp, Dept Urol, D-07740 Jena, Germany Univ Colorado, Hlth Sci Ctr, Dept Urol, Neurourol Unit, Denver, CO USA Univ Colorado Denver CO USA r, Dept Urol, Neurourol Unit, Denver, CO USA Yamagata Univ, Sch Med, Dept Urol, Yamagata 99023, Japan Yamagata Univ Yamagata Japan 99023 Med, Dept Urol, Yamagata 99023, Japan
Titolo Testata:
EUROPEAN UROLOGY
fascicolo: 4, volume: 38, anno: 2000,
pagine: 393 - 399
SICI:
0302-2838(200010)38:4<393:PIOBTT>2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Soggetto:
DETRUSOR-SPHINCTER DYSSYNERGIA; GENE-RELATED PEPTIDE; CORD INJURY PATIENTS; AFFERENT-FIBERS; SKELETAL-MUSCLE; RECEPTORS; PROSTATODYNIA; REFLEX; RAT; EXTRAVASATION;
Keywords:
chronic prostatic pain; pelvic floor muscle dysfunction; botulinum toxin type A; urodynamics;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
48
Recensione:
Indirizzi per estratti:
Indirizzo: Zermann, DH Univ Jena Hosp, Dept Urol, D-07740 Jena, Germany Univ Jena Hosp Jena Germany D-07740 l, D-07740 Jena, Germany
Citazione:
D.H. Zermann et al., "Perisphincteric injection of botulinum toxin type A - A treatment option for patients with chronic prostatic pain?", EUR UROL, 38(4), 2000, pp. 393-399

Abstract

Background: Chronic prostatic pain is still a diagnostic and therapeutic problem. The clinical observation that prostatic and pelvic pain is accompanied by motoric and sensoric disorders of the pelvic floor muscles led to the hypothesis that prostatic pain roots in a changed processing of afferent and efferent information with the central nervous system (CNS). Methods: Neuro-urological work-up of 11 male patients with chronic prostatic pain was completed. This included a clinical evaluation of pelvic floor function, urodynamic investigation of bladder and urethra function and a cystoscopy to exclude morphological aberrations. A transurethral perisphincteric injection of 200 units botulinum toxin type A (BTX) was followed by a 2- to 4-week visit to evaluate their influence on the neuro-urological symptomatology. Results: All chronic prostatic pain patients suffered from a pathological pelvic floor tenderness, an inability of sufficient conscious pelvic floor control, a urethral hypersensitivity/hyperalgesia and a urethral muscle hyperactivity. Basic parameters of bladder function (capacity, sensitivity, compliance) were normal. The BTX injection was followed by a pelvic floor muscle weakening and a relief of prostatic pain and urethral hypersensitivity/hyperalgesia. A botulinum-related decrease of the functional urethral length, the urethral sphincter closure pressure, the postvoid residual volume and an increase of the peak and average uroflow were objectivated. Conclusion: A weakening of the urethral sphincter muscle via blocking acetylcholine release by BTX injection is followed by pain relief and symptom improvement. It can therefore be concluded that a barrage of nociceptive information from the dysfunctional pelvic floor overflood the CNS and induce achanged CNS processing. Interrupting the efferent branch of the disturbed central circle is one opportunity to treat chronic prostatic pain. Copyright (C) 2000 S. Karger AG, Basel.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/09/20 alle ore 12:09:10