Botox For Bladder Incontinence
Botox…for Your Bladder?
It's not just for wrinkles anymore — new research shows that botulinum toxin injections could help quiet the call of nature for people with a common type of urinary incontinence.
By Allison Takeda
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TUESDAY, Mar. 13, 2012 —Going to the bathroom probably isn’t something you think about very often — unless, perhaps, you’re one of the millions of people who have urinary incontinence, in which case you might think about it a lot. When you have incontinence, nature calls often and without warning, like a telemarketer or your mother-in-law. Unlike your mother-in-law, however, nature won’t wait until you have time to answer.
Botox for incontinence is not new: Some military hospitals and private practices have been using it for years, and in August, the U.S. Food and Drug Administration approved it as a treatment for bladder control issues resulting from neurological conditions such as spinal cord injury and multiple sclerosis. Until now, however, not much was known about its benefit for other, more common types of incontinence, such as overactive bladder.
Overactive bladder — which is characterized by a sudden, urgent need to urinate — is a type of urinary incontinence affecting around 200 million people worldwide, three-quarters of whom are women. Treatment options have traditionally included bladder retraining, pelvic floor exercises, and a class of drugs known as anticholinergics, which work by blocking nerve signals related to bladder muscle contraction. These measures work for some people — but not all. In severe cases, patients may actually require incontinence surgery to remedy the problem. This new study, the largest of its kind, could change that.
Led by Douglas Tincello, MD, researchers from the University of Leicester recruited 240 women with severe detrusor overactivity, or DO, (defined as frequent random contraction of the bladder muscles) who had already tried two different drug treatments with little or no success. About half of the women were given injections of Botox; the others received a saline placebo. Among those in the former group, Dr. Tincello reports, urgency dropped from six times a day to less than one time a day, and 40 percent regained complete continence after just six weeks — an effect that lasted for up to six months after treatment.
“We found that a single treatment with botulinum toxin was a very effective treatment for the symptoms of DO,” Dr. Tincello said in a press release about the study. “Patients were able to pass water one or two times less often during the day, and also noticed far fewer times when they had bad feelings of urgency and had to rush to the bathroom.”
The relief was lasting, Tincello added, but not without complications. About one in eight women actually had some temporary difficulty emptying her bladder after treatment (due to paralysis of the muscles involved in contraction) and had to use a catheter for relief. For people with chronic, severe incontinence, however, that may be a small price to pay.
“I am very excited by our work; this bladder condition is very frustrating for me as a doctor, and botulinum toxin works so much better than the drugs we have,” Tincello said in the release.
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