**Chien-Hsu Chen 1, Pradeep Tyagi <sup>2</sup> and Yao-Chi Chuang 1,\***


Received: 14 August 2019; Accepted: 9 October 2019; Published: 11 October 2019

**Abstract:** Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) has a negative impact on the quality of life, and its etiology still remains unknown. Although many treatment protocols have been evaluated in CP/CPPS, the outcomes have usually been disappointing. Botulinum neurotoxin A (BoNT-A), produced from *Clostridium botulinum*, has been widely used to lower urinary tract dysfunctions such as detrusor sphincter dyssynergia, refractory overactive bladder, interstitial cystitis/bladder pain syndromes, benign prostatic hyperplasia, and CP/CPPS in urology. Here, we review the published evidence from animal models to clinical studies for inferring the mechanism of action underlying the therapeutic efficacy of BoNT in CP/CPPS. Animal studies demonstrated that BoNT-A, a potent inhibitor of neuroexocytosis, impacts the release of sensory neurotransmitters and inflammatory mediators. This pharmacological action of BoNT-A showed promise of relieving the pain of CP/CPPS in placebo-controlled and open-label BoNT-A and has the potential to serve as an adjunct treatment for achieving better treatment outcomes in CP/CPPS patients.

**Keywords:** botulinum toxin; chronic prostatitis

**Key Contribution:** This article reviewed basic research and the clinical results of botulinum toxin A in patients with CP/CPPS and suggested the potential to improve the therapeutic outcome.
