The following is a summary of the “Intra-Cavernosal Injection of Botulinum Toxin in the Treatment of Erectile Dysfunction: a Systematic Review and Meta-Analysis” published in the September 2022 issue of Urology b Zahr et al.

For a study, researchers sought to assess the usefulness of botulinum toxin as a potential therapy option for erectile dysfunction that avoids painful and permanent operations.

The period covered by the evaluation was from January 1990 to July 31, 2021. To locate English-language research looking at the effects of botulinum toxin on erectile dysfunction, search engines such as PubMed, Embase, and Medline databases were employed. The review comprised a total of seven research, including two pre-clinical ones. A meta-analysis was conducted on 3 results shared by at least 2 research studies. Erection Hardness Score (EHS), Peak Systolic Velocity in Cavernosal Artery (PSV), and the Sexual Health Inventory for Men (SHIM) score were a few of the other factors evaluated.

With a mean difference (MD) of 10.82 [4.99, 16.65] and heterogeneity of I2=61%, intracavernosal injection (ICI) of botulinum toxin (BoNT-A) on PSV was shown to have a clear advantage. With an MD of 0.7 [0.47, 0.93] and I2=94% heterogeneity, EHS findings favored BoNT-A over placebo. With an I2 heterogeneity of 85%, no statistically significant difference was identified for the SHIM score (MD 0.58 [-0.03, 1.20]).

Statistical significance for the benefit of BoNT-A in terms of EHS & PSV. However, the following restrictions should be considered when interpreting the statistical significance: the small sample size, the variability in data collection, the bias in patient selection, and the clinical importance of the detected differences. To further understand its therapeutic benefit, ICI of BoNT-A should be restricted to clinical investigations.