Posts Tagged ‘Botox’

Overactieve Bladder-Botox May Be a Solution

March 16, 2014

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.

Urine Incontinence — It’s Nothing to Sneeze At

January 17, 2014

One of life’s most embarrassing experiences is not being able to control your urination and soiling your clothes forcing you to leave any situation where you are engaged with others. It is one of the last medical conditions to remain in the closet as many men and women fail to seek medical attention for this common problem.
This blog will discuss the 4 types of urinary incontinence and what treatment options are available for this common problem.

Urge Incontinence occurs in women with an overactive bladder who may not be able to get to the toilet in time to prevent leakage, even though they tighten up all of their pelvic muscles, because they can’t control the bladder and keep urine in. Overactive bladder that leads to urge incontinence affects about 17 percent of women, but it increases to over 50 percent after menopause. Overactive bladder isn’t a normal part of aging.

Stress incontinence is a much more common type of incontinence. Menopause contributes to this problem, but stretching and tearing of the pelvic muscles during childbirth definitely sets the stage. The reduced muscle tone causes the urethra to sag. When pressure builds up in the abdomen from a cough, sneeze, laugh, jump or lift, internal organs put pressure on the bladder and a small amount of urine may escape.

Overflow incontinence occurs when more urine collects in the bladder than the bladder can hold and the excess urine leaks out. It can be caused by blockage of the urinary tract or nerve damage caused by conditions such as diabetes, stroke, or injury.

Functional incontinence is not really a problem with the urinary tract. It happens to people who can’t move quickly, who have eye problems or who suffer from confusion or memory loss. They simply can’t get to the bathroom in time.

Certain prescription drugs such as diuretics and some tranquilizers, and smoking and eating spicy foods or artificial sweeteners, or drinking alcohol and caffeine can irritate the bladder and worsen incontinence.

Mixed incontinence is a combination of both stress and urge incontinence.

Today, there are many more options to consider, from medications, pelvic floor physical therapy, and surgery. The first step is to have a work up to diagnose the underlying problem so that an appropriate treatment plan can be put into place. Sometimes more than one treatment is needed.
Treatment options include:
1. Bladder training — This approach teaches you to urinate only at scheduled times and waiting longer between trips to the bathroom. Start by going to the bathroom every 30 to 60 minutes while you are awake, even if you don’t have to go. After about one week, slowly increase the time interval by 30 minutes every week.

2. Kegel exercises — Dr. Arnold Kegel, a gynecologist at the University of Southern California, developed the exercises to strengthen pelvic floor muscles in 1948. Kegel exercises are often the first line of treatment for the millions of women in the U.S. suffering from unexpected bladder leakage due to coughing, sneezing, laughing or exercise. This if defined as stress incontinence but many women experience frustration because they unknowingly don’t perform the Kegels effectively, which leads to no improvement in symptoms. Most men or women need to do the exercises for 3-6 months before any changes will occur.

3. Pelvic Floor Electrical Stimulation with Biofeedback Therapy — This treatment uses computer graphs and sounds you can hear to show you which muscles you are exercising so you can perfect the exercises. Physical therapists and other professionals specially trained in problems related to women’s health teach exercises for the pelvic floor, trunk, back and extremities that can help strengthen the pelvic muscles and improve bladder control. The physical therapist may use devices that use mild, comfortable, electrical stimulation to train the bladder muscles when and how to squeeze.

4. InTone is a new FDA listed Class II Medical Device for home use that has been shown to effectively strengthen the pelvic floormuscles and helps to prevent embarrassing leakage without surgery or medication and can be done in the privacy of home. InTone is like a personal trainer for Kegel exercises.

5. Medications — Estrogen can be very helpful in improving the symptoms of some cases of incontinence. Studies have demonstrated improvement in 40- 70 percent of women. I have found that estrogen cream (one fourth to half an applicator) works better than either tablets or patches for this particular problem. Medications called smooth muscle relaxants (examples are oxybutynin and tolterodine) can also help if the problem is caused by abnormal bladder contractions.

6. Pessaries — These donut-like plastic or rubber rings are similar to a diaphragm used for birth control. They are fit into the vagina to lift and offer added support for the bladder when the pelvic muscles are weak.

7. Surgery — There are many operations that have been developed to support the bladder and improve or correct incontinence. Women don’t need to have a hysterectomy in order to control urinary incontinence. Most of these operations for incontinence can be performed as one-day surgeries.

8. Botox– If you don’t respond to oral medications, you may be a candidate for Botox injections directly into the bladder muscle. This, too, can be done as a one-day stay procedure and usually produces relief of symptoms of frequency of urination and urgency of urination with urge incontinence

Bottom Line: Women don’t have to suffer in silence. Successful treatment options are available and most women can be helped and made more comfortable and reduce their embarrassment.

Botox for Migraine Headaches-May Help More Than Your Wrinkles

November 23, 2010

The FDA has just approved the use of Botox for the prevention of migraine headaches.  Botox is given every three months as multiple injections around the head and neck to try to decrease future headache symptoms.  Unfortunately, the most common adverse reactions are neck pain and headaches!  Hard to imagine a treatment that causes the problem you are trying to cure!  But I know people with chronic migraine headaches and they are willing to try almost anything.  If you have this problem, you might want to ask your doctor about these injections.