When you think “BOTOX,” you probably think of facial enhancement. But botulinum toxin has a new and evidently safe use for a condition that strikes up to 20% of all adults over the age of 40. That would be urinary incontinence. Talk about a health breakthrough.
An overactive bladder is a form of urinary incontinence. Symptoms include having to rush to the toilet, nocturia (the need to interrupt sleep at night to urinate) and having wetting accidents before reaching the toilet. In general, urinary incontinence is more common in women and can be very embarrassing, taking a toll on day-to-day life.
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It is caused by the bladder muscle being overactive and contracting at random moments. This is called “detrusor overactivity” (DO). Doctor’s advice usually consists of pelvic floor muscle exercises, drinking more fluids, and taking a range of drugs. This is somewhat effective, but many patients gain no relief or have bad side effects.
The four-year study involved 240 women with severe DO who had failed to get better after two different drug treatments. They found one treatment with BOTOX was very effective to clear symptoms of DO. Patients were able to pass water one or two times less often during the day. They also experienced far fewer bad feelings of urgency and having to rush to the bathroom.
Botox meant that that urgency dropped from six times a day to about one a day. Plus, four in 10 women become completely normal, without bladder problems, after six weeks. One-third was normal six months after treatment. (BOTOX benefits seemed to wear off after six months.)
Now for the negative bits: about one in eight women had some difficulty emptying their bladder at some time in the six months after treatment. This was because the bladder muscle was paralyzed. This was treated by teaching the women to use disposable catheters. But this side effect wore off about half a year later.
This was the first clinical trial of botulinum toxin in women with DO. It provides a large body of evidence detailing how effective and safe botulinum toxin treatment may be. The effects appear much greater than a six-month course of drugs. So BOTOX may turn out to be a more inexpensive way of treating this common condition.
If you suffer urinary incontinence and are seeking a solution, speak to your doctor about this possibility. And compare it to drug treatments in terms of cost and side effects.
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