Prostatitis Clinical Trial
Official title:
Injection of Botulinum Toxin Type A Into the External Urethral Sphincter for Male Patients Suffering From Chronic Prostatitis/Chronic Pelvic Pain Syndrome (NIH Cat. III): a Prospective, Double-blind and Placebo-controlled Clinical Trial
The aim of this randomized placebo-controlled study is to demonstrate the efficiency and safety of the injection of Botulinum Toxin Type A (200 Units) into the external urethral sphincter for the treatment of chronic prostatitis/chronic pelvic pain.
The treatment of the male CP/CPPS is often as unsuccessful as frustrating for patients and
doctors. Because of that patients change their general practitioners or urologists quite
regularly. One of the major problems is the unknown pathomechanism of the disease. Most
patients are suffering from irritative voiding symptoms and a dysfunction of the pelvic
floor. By looking at the various (non-) conservative therapeutical strategies it becomes
quite clear that there is no unique and convincing therapeutical strategy.
At present Botulinum-Toxin Type A (BTX A) is widely used in the urological field especially
for para-/tetraplegics patients having trouble with neurogenic bladder dysfunction. It has
been reported in case series (doses: 200U and 30U) that BTX A injected into the external
urethral sphincter is able to reduce the symptoms without provoking incontinence. This is
implied with the hypothesis that obstructive voiding symptoms because of a CP/CPPS are
associated with an incomplete relaxation of the bladder neck and the external urethral
sphincter.
After having given their informed consent, patients undergo a screening visit and baseline
evaluation including patients history, clinical examination, NIH-CPSI and
IPSS-questionnaires, micturition diary, sonography, 4-glass test and urodynamics. Patients
fulfilling the study eligibility criteria are randomized to receive intrasphincteric
injection of either BTX A or placebo. There will be 5 follow-up visits including a
post-treatment follow-up after 1 year.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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