A-botulinic Toxin for Symptomatic Benign Prostate Hypertrophy (PROTOX)

This study is currently recruiting participants.
Verified November 2013 by University Hospital, Bordeaux
Information provided by (Responsible Party):
University Hospital, Bordeaux
ClinicalTrials.gov Identifier:
First received: January 11, 2011
Last updated: November 5, 2013
Last verified: November 2013

BPH is very common in elderly men, it is a stromal as well as epithelial invasion of the prostatic gland. Due to an imbalance between growth and apoptosis cellular mechanisms that are not fully elucidated. It is the same for symptomatology and urodynamic obstruction without clear identification of the part which is due to static phenomena (volume increase) and dynamic reports (α 1-receptor action). That explains the multiplicity of treatments and the difficulty of therapeutic indications between monitoring, medical treatment, and surgical operation. Experimental studies of BONT-A intra prostatic injection on animal and human models, have shown efficacy in BPH cell apoptosis, decrease in cell growth and decline in the number of adrenergic α1 receptors.

Many studies in humans show therapeutic efficacy leading to a possible use of BONT-A as mini invasive treatment of symptomatic BPH, as an alternative to medical or surgical treatment.

PROTOX study proposes to evaluate tolerance and effectiveness of the intra-prostatique BONT-A injection in the treatment of symptomatic BPH.

Condition Intervention Phase
Prostatic Hyperplasia
Drug: BONT-A intra-prostatic injection
Drug: Optimized medical BPH treatment
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Study of the Effectiveness and the Tolerance of Intraprostatic A-botulinic Toxin Injection, in the Treatment of Symptomatic Benign Prostate Hypertrophy.

Further study details as provided by University Hospital, Bordeaux:

Primary Outcome Measures:
  • Evaluation of the patient with auto-questionnaire IPSS urinary symptomatology: questions 1 to 7 (0 to 35 score). [ Time Frame: 4 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • IPSS question 8 (score 0 to 6) [ Time Frame: 18 months ] [ Designated as safety issue: No ]
  • Uroflowmetry (Qmax in ml/s) [ Time Frame: 18 months ] [ Designated as safety issue: No ]
  • • measure the post-voiding residue assessed by supra pubic ultrasound or urinary drainage [ Time Frame: 18 months ] [ Designated as safety issue: No ]
  • measure of prostate volume assessed by endo-rectal ultrasound [ Time Frame: 18 months ] [ Designated as safety issue: No ]
  • measurement of the erectile function by auto questionnaire IIEF-5 (0 to 24 score) [ Time Frame: 18 months ] [ Designated as safety issue: No ]
  • urinary continence Evaluation by ICS 1 (0 to 23 score) and ICS 2 (0 to 12 score) [ Time Frame: 18 months ] [ Designated as safety issue: No ]
  • bladder emptying mode (spontaneous or permanent probe) [ Time Frame: 18 months ] [ Designated as safety issue: No ]
  • specific treatment for BPH (alpha blocking, 5 alpha reductase inhibitor and/or phytotherapy) [ Time Frame: 18 months ] [ Designated as safety issue: No ]
  • Urinary retention [ Time Frame: 18 months ] [ Designated as safety issue: No ]
  • Surgical treatment [ Time Frame: 18 months ] [ Designated as safety issue: No ]
  • profile of gene and protein expression on the first urine flow after prostate massage [ Time Frame: 18 months ] [ Designated as safety issue: No ]

Estimated Enrollment: 226
Study Start Date: January 2011
Estimated Study Completion Date: July 2015
Estimated Primary Completion Date: July 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: BONT-A intra-prostatic injection Drug: BONT-A intra-prostatic injection

• Intra prostatic injection of 200 IU of BONT-A (2 x 100 IU to dilute in 10 cc salted serum), divided into 4 injections, 2 in each prostate lobe for a volume intra injected 2.5 cc per site.

Interruption of the medical therapy 1 month after the injection;

Active Comparator: optimized medical BPH treatment Drug: Optimized medical BPH treatment
Optimization of the medical therapy according to recent guidelines


Ages Eligible for Study:   50 Years to 85 Years
Genders Eligible for Study:   Male
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Patient aged 50 to 85;
  • Obstructive or irritative urinary symptomatology linked to a BPH;
  • Score IPSS moderate to severe (8-19: moderate; 20-35: severe) or IPSS ≤ 7 in patient medically treated for symptomatic BPH;
  • Increase in prostate volume on the rectal touch or ultrasound;
  • Free consent, informed and written, dated and signed by the patient and the investigator (at the latest the day inclusion and before any examination requires the study);
  • Subject affiliate or beneficiary of a social protection

Exclusion Criteria:

  • stenosis of the urethra confirmed by endoscopic or radiological examination;
  • prostate cancer suspicion;
  • medical past history of surgery, radiotherapy or pelvic trauma (, breach of the urethra, pubic symphysis disjunction);
  • surgical resection of the prostate (adenomecty);
  • clinical or paraclinical signs of vesical sphincterial disynergia; chronic urinary retention > 500 ml;
  • BPH complications making surgery necessary: effects on the upper urinary tract: dilatation or renal obstructive insufficiency, bladder stones or diverticula.
  • patient previously treated by botulic toxin (whatever injection site);
  • Persons unable to understand the course of the study.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01275521

Contact: Grégoire ROBERT, MD (33) - 05 56 79 55 47 gregroire.robert@chu-bordeaux.fr
Contact: Philippe BALLANGER, Professor philippe.ballanger@chu-bordeaux.fr

Service d'Urologie - CH du Pays d'Aix - Avenue de Tamaris Recruiting
AIX-en-PROVENCE, France, 13616
Principal Investigator: Marc FOURMARIER, MD         
Service d'Urologie, CHU d'Angers 4, rue Larrey Recruiting
Angers, France, 49933
Principal Investigator: Abdel-Rahmene AZZOUZI, MD         
Service d'urologie, Groupe Hospitalier Pellegrin, place Amélie Raba Léon Recruiting
Bordeaux, France, 33076
Contact: Grégoire ROBERT, MD    (33) 05 56 79 55 47    gregoire.robert@chu-bordeaux.fr   
Principal Investigator: Grégoire ROBERT, MD         
Sub-Investigator: Philippe BALLANGER, Professor         
Service d'urologie - APHP Henri Mondor - 51, avenue du Maréchal de Lattre de Tassigny Recruiting
Creteil, France, 94000
Principal Investigator: Alexandre de la TAILLE, Professor         
Service d'urologie - CHU de Limoges - 2, avenue Martin Luther King Recruiting
Limoges, France, 87052
Principal Investigator: Aurélien DESCAZEAUD, MD         
Service d'urologie - Hôpital de la Conception - 147 boulevard Baille Recruiting
Marseille, France, 13005
Principal Investigator: Gilles KARSENTY, MD         
Sub-Investigator: Véronique DELAPORTE, MD         
Clinique Mutualiste Beausoleil Not yet recruiting
Montpellier, France, 33070
Contact: Xavier REBILLARD, MD         
Principal Investigator: Xavier REBILLARD, MD         
Sub-Investigator: Antoine FAIX, MD         
Service d'Urologie - APHP Hôpital Saint Louis - 1, avenue Claude-vellefaux Recruiting
Paris, France, 75475
Principal Investigator: François DESGRANDCHAMPS, Professor         
Sub-Investigator: Paul Joseph MERIA, MD         
Service d'Urologie - APHP Hopital Cochin - 27, Rue du faubourg Saint Jacques Not yet recruiting
Paris, France, 75014
Principal Investigator: Nicolas BARRY DELONGCHAMPS, MD         
Service d'Urologie - Hospices Civls de Lyon - 165 chemin du grand Revoyet Recruiting
Pierre Benite, France, 69495
Sub-Investigator: Marian DEVONEC, Professor         
Service d'urologie - CHRU Strasbourg - BP 426 Recruiting
Strasbourg, France, 67091
Principal Investigator: Christian SAUSSINE, Professor         
Sponsors and Collaborators
University Hospital, Bordeaux
Principal Investigator: Grégoire ROBERT, MD University Hospital, Bordeaux
Study Chair: Antoine BENARD, MD University Hospital, Bordeaux
  More Information


Responsible Party: University Hospital, Bordeaux
ClinicalTrials.gov Identifier: NCT01275521     History of Changes
Other Study ID Numbers: CHUBX 2010/39
Study First Received: January 11, 2011
Last Updated: November 5, 2013
Health Authority: France: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis)

Additional relevant MeSH terms:
Prostatic Hyperplasia
Prostatic Diseases
Genital Diseases, Male
Pathologic Processes
Pathological Conditions, Anatomical

ClinicalTrials.gov processed this record on April 21, 2014