Overactive bladder or urinary frequency, urgency and urge incontinence affects millions of American men and women. Most men and women can be helped with medication. However, some suffers are unable to achieve any relief with medication or suffer from the side effects so that taking the medication is not possible. Now a new FDA treatment using Botox has been tested for those patients, mostly women, who have difficult to treat overactive bladder.
Botulinum toxin, otherwise known as Botox, has been historically used by the plastic surgery community to help alleviate wrinkles on the face. Botox relaxes muscular tissue. When used in the bladder, it can relax the bladder muscle resulting in fewer visits to the bathroom. Women who use the bathroom more than 8 times during the day and may be experiencing frequent bathroom trips at night may benefit from Botox treatment. Botox has been determined to be a safe and effective treatment for overactive bladder and urinary incontinence.
The procedure of Botox injections is simple, quick, and can easily be done in the office setting. It is typically done with the help of a cystoscope under local anesthesia but can also be done in the same day surgery setting under monitored anesthesia depending on patient preference. There are no incisions. The bladder is examined carefully with the cystoscope and Botox is injected into the bladder wall through a special needle passed through the cystoscope directly into the bladder muscle. Most patients tolerate the procedure very well, maximum benefit is obtained in about 2 weeks, and the treatment lasts 4 to 9 months and then can be repeated again.
Patients usually notice a reduction in their urinary frequency and urgency about 5 days after the procedure. If leakage occurred before Botox, there should be no leakage afterwards. There are a few reported side effects such as blood in the urine after the procedure but then clearing within a few days. Bladder infection may occur as a result of the minimally invasive procedure, so antibiotics are typically given as a precaution after the procedure. About 1 in 10 to 1 in 20 patients describe difficulty emptying the bladder after the procedure and may need to pass a urinary catheter intermittently to achieve complete emptying of the bladder for a few weeks post op.
Bottom Line: Overactive bladder is a common problem that affects the quality of lives of millions of American men and women. Most of patients can be helped with medication. Now Botox is available for those who find the medication ineffective or suffer from intolerable side effects.