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Botulinum Toxin Type A for the Treatment of Male Chronic Pelvic Pain Syndrome (BTX-URO-01)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00464373
Recruitment Status : Terminated (Slow accrual.)
First Posted : April 23, 2007
Last Update Posted : February 3, 2014
Information provided by (Responsible Party):
Daniel Stephan Engeler, Cantonal Hospital of St. Gallen

Brief Summary:
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.

Condition or disease Intervention/treatment Phase
Chronic Prostatitis With Chronic Pelvic Pain Syndrome Prostatitis Drug: Botulinum Toxin Type A Drug: Placebo Phase 3

Detailed Description:

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.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 11 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
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
Study Start Date : April 2007
Actual Primary Completion Date : May 2013
Actual Study Completion Date : June 2013

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Botox Pelvic Pain

Arm Intervention/treatment
Experimental: 1
Botulinum Toxin Type A 200 U in 4ml NaCl 0.9%
Drug: Botulinum Toxin Type A
Single intrasphincteric injection at the 3,6,9, and 12 o'clock positions of the external urethral sphincter (1 ml of drug solution each)
Other Name: Botox

Placebo Comparator: 2
4ml NaCl 0.9%
Drug: Placebo
4ml NaCl 0.9%

Primary Outcome Measures :
  1. NIH-CPSI Total Score [ Time Frame: 1 year ]

Secondary Outcome Measures :
  1. NIH-CPSI Subscales [ Time Frame: 1 year ]
  2. Standardized questions for the assessment of the treatment outcome [ Time Frame: 1 year ]
  3. International prostate symptom score (I-PSS) [ Time Frame: 1 year ]

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years to 70 Years   (Adult, Older Adult)
Sexes Eligible for Study:   Male
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • CPPS NIH III (symptoms over 3 months during the last 6 months, 4 glass-test)
  • Pain Score ≥ 4

Exclusion Criteria:

  • During the last month: intake of antibiotics, alpha receptor blockers, anticholinergics; intake of analgesics containing opioids (longer than 4 days); participating in a different clinical trial
  • During the last 3 months:documented urinary infection, epididymitis, positive urinary culture; status post biopsy of the prostate gland; STD: Gonorrhea, Chlamydia, Mycoplasm, Trichomonads
  • During the last 6 months: Finasteride or any other 5α-reductase inhibitor
  • During the last 12 months: status post any surgery on the prostate gland; genital herpes; not adjustable hypertension, angina pectoris, heart failure (NYHA III-IV), Status post myocardial infarction, coronary bypass surgery or coronary dilatation
  • During the last 24 months: cerebral insult, TIA; active disease of the liver
  • Other urological diseases like prostate cancer, bladder cancer, status post radiation of the small pelvis, chemotherapy (intravesical or systemic)
  • Urinary catheter
  • Residual urine > 200ml
  • Serum creatinine > 200µmol/l
  • Status post injection of BTX A, hypersensitivity concerning any substances of content of BTX, myasthenia gravis
  • Any kind of cancer
  • Active inflammation (except the prostate gland)
  • Neurological or psychological disease making signing of a consent form or behaving according to a study protocol impossible
  • Abuse of drugs or alcohol during last 5 years
  • Any disease that may influence the results according to the opinion of the medical doctor

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00464373

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Department of Urology, Cantonal Hospital of St. Gallen
St. Gallen, Switzerland, 9007
Sponsors and Collaborators
Daniel Stephan Engeler
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Principal Investigator: Daniel S Engeler, MD Department of Urology, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland
Study Director: Hans-Peter Schmid, MD Department of Urology, Cantonal Hospital of St. Gallen
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Responsible Party: Daniel Stephan Engeler, Dr. med., Cantonal Hospital of St. Gallen Identifier: NCT00464373    
Other Study ID Numbers: BTX-URO-01
EKSG 06/056
First Posted: April 23, 2007    Key Record Dates
Last Update Posted: February 3, 2014
Last Verified: January 2014
Keywords provided by Daniel Stephan Engeler, Cantonal Hospital of St. Gallen:
Chronic Prostatitis with Chronic Pelvic Pain Syndrome
Botulinum Toxin Type A
Drug therapy
Injections, intramuscular
Additional relevant MeSH terms:
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Pelvic Pain
Chronic Disease
Somatoform Disorders
Pathologic Processes
Mental Disorders
Neurologic Manifestations
Prostatic Diseases
Disease Attributes
Botulinum Toxins
Botulinum Toxins, Type A
Acetylcholine Release Inhibitors
Membrane Transport Modulators
Molecular Mechanisms of Pharmacological Action
Cholinergic Agents
Neurotransmitter Agents
Physiological Effects of Drugs
Neuromuscular Agents
Peripheral Nervous System Agents