Abstract：
UNASSIGNED: Botulinum toxin A (BoNT-A) injections in the prostate gland have been used as a minimally invasive option for treating bladder outlet obstruction (BOO). However, the efficacy of transurethral BoNT-A injections for BOO is not well established in the literature. The aim of this study is to collect evidence on the efficacy of transurethral BoNT-A injections for the treatment of BOO.
UNASSIGNED: This systematic review and meta-analyses was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. A systematic literature search was performed till December 2022. The study population consisted of adult patients diagnosed with BOO, who underwent transurethral injections of BoNT-A for the treatment of BOO.
UNASSIGNED: Out of 883 records, we identified seven studies enrolling 232 participants, of which only one nonrandomized controlled trial was found. Four prospective studies and two retrospective studies. Three studies included patients with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) and were included in the meta-analysis. Three studies included patients with urethral sphincter hyperactivity. One study included patients with primary bladder neck disease (PBND). All studies showed significant improvements from baseline in maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS), and postvoid residual (PVR) at 3 and 6 months. The adverse events were mild in all studies. Hematuria, UTI, and urinary retention were reported across all studies.
UNASSIGNED: In conclusion, transurethral BoNT-A injections have been shown to improve LUTS, QoL, and urodynamic parameters of individuals with BOO at 3 and 6 months after injections, and no serious adverse effects have been reported. However, data on the long-term benefits of this treatment are scarce, and more prospective, randomized studies with larger samples examining various injection techniques, dosages, and extended follow-up of recurrent injections are needed.
UNASSIGNED: This systematic review and meta-analyses was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. A systematic literature search was performed till December 2022. The study population consisted of adult patients diagnosed with BOO, who underwent transurethral injections of BoNT-A for the treatment of BOO.
UNASSIGNED: Out of 883 records, we identified seven studies enrolling 232 participants, of which only one nonrandomized controlled trial was found. Four prospective studies and two retrospective studies. Three studies included patients with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) and were included in the meta-analysis. Three studies included patients with urethral sphincter hyperactivity. One study included patients with primary bladder neck disease (PBND). All studies showed significant improvements from baseline in maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS), and postvoid residual (PVR) at 3 and 6 months. The adverse events were mild in all studies. Hematuria, UTI, and urinary retention were reported across all studies.
UNASSIGNED: In conclusion, transurethral BoNT-A injections have been shown to improve LUTS, QoL, and urodynamic parameters of individuals with BOO at 3 and 6 months after injections, and no serious adverse effects have been reported. However, data on the long-term benefits of this treatment are scarce, and more prospective, randomized studies with larger samples examining various injection techniques, dosages, and extended follow-up of recurrent injections are needed.
摘要：
■在前列腺中注射肉毒杆菌毒素A（BoNT-A）已被用作治疗膀胱出口梗阻（BOO）的微创选择。然而,在文献中,经尿道注射BoNT-A治疗BOO的疗效尚不明确.这项研究的目的是收集经尿道BoNT-A注射治疗BOO疗效的证据。
■本系统评价和荟萃分析是根据系统评价和荟萃分析的首选报告项目（PRISMA）声明进行的。进行了系统的文献检索，直至2022年12月。研究人群包括诊断为BOO的成年患者，谁接受了经尿道注射BoNT-A治疗BOO。
■在883条记录中，我们确定了七项研究，招募了232名参与者，其中仅发现一项非随机对照试验。四项前瞻性研究和两项回顾性研究。三项研究包括下尿路症状（LUTS）和良性前列腺增生（BPH）患者，并纳入荟萃分析。三项研究包括尿道括约肌活动过度的患者。一项研究包括患有原发性膀胱颈疾病(PBND)的患者。所有研究均显示最大尿流率（Qmax）较基线有显著改善，国际前列腺症状评分（IPSS）3个月和6个月时的残存（PVR）。所有研究中的不良事件均为轻度。血尿,UTI,所有研究均报告尿潴留.
■总而言之，经尿道注射BoNT-A可改善LUTS,QoL,以及注射后3个月和6个月患有BOO的个体的尿动力学参数，没有严重不良反应的报道。然而,关于这种治疗的长期益处的数据很少，更有前瞻性，用较大样本进行随机研究，检查各种注射技术，剂量,需要延长反复注射的随访时间.
■本系统评价和荟萃分析是根据系统评价和荟萃分析的首选报告项目（PRISMA）声明进行的。进行了系统的文献检索，直至2022年12月。研究人群包括诊断为BOO的成年患者，谁接受了经尿道注射BoNT-A治疗BOO。
■在883条记录中，我们确定了七项研究，招募了232名参与者，其中仅发现一项非随机对照试验。四项前瞻性研究和两项回顾性研究。三项研究包括下尿路症状（LUTS）和良性前列腺增生（BPH）患者，并纳入荟萃分析。三项研究包括尿道括约肌活动过度的患者。一项研究包括患有原发性膀胱颈疾病(PBND)的患者。所有研究均显示最大尿流率（Qmax）较基线有显著改善，国际前列腺症状评分（IPSS）3个月和6个月时的残存（PVR）。所有研究中的不良事件均为轻度。血尿,UTI,所有研究均报告尿潴留.
■总而言之，经尿道注射BoNT-A可改善LUTS,QoL,以及注射后3个月和6个月患有BOO的个体的尿动力学参数，没有严重不良反应的报道。然而,关于这种治疗的长期益处的数据很少，更有前瞻性，用较大样本进行随机研究，检查各种注射技术，剂量,需要延长反复注射的随访时间.
