Effects of botulinum toxin on the glandular portion of the prostate: pathophysiologic bases, mechanism of action, and evidence

Abstract

Botulinum toxin is a potent neurotoxin that inhibits neuromuscular junctions by blocking the release of acetylcholine and desensitizes sensory nerves. In the prostate, it effects are not limited to the neuromuscular junction, but also affect the neuroglandular junction, placing the intraprostatic injection of botulinum toxin among the new treatment options for benign prostatic hyperplasia. Considering its potential as an effective therapy in prostate conditions, while at the same time its mechanisms of action are not clear, the aim of the present review was to organize the current evidence and describe the currently known pathophysiologic bases and mechanism of action involved to encourage new research. After conducting the review of the evidence, it was concluded that botulinum toxin could induce involution of the prostate in rats, dogs, and humans, without causing local inflammation or significant systemic side effects, suggesting the possibility of its use in benign or malignant prostate lesions.