Botox can treat incontinence

Contributing ColumnistJuly 4, 2014 

Men and women alike have turned to Botox to reverse the signs of aging, but now there is a new medical use for the injections. Botox is being used to treat overactive bladder.

Overactive bladder is the sudden, uncontrollable urge to urinate, which can lead to incontinence. It can affect both men and women of all ages, and risk for the condition increases with age. While it is more frequent in women, men may experience overactive bladder if they have prostate problems or following prostate surgery.

Individuals with overactive bladder often awaken multiple times in the night to urinate and experience incontinence. This condition is urge incontinence — incontinence due to frequent urge to urinate.

Many patients with overactive bladder experience poor sleep and increased stress because of frequent urination. Poor sleep can lead to other health problems, including a weakened immune system, lack of energy and even depression.

The symptoms are commonly treated by medication. While there are several medications on the market to choose from, they all have side effects. And unfortunately, the less expensive medications often have more side effects. Common side effects include dry mouth (which can get worse if dosage increases are needed), dry eyes, constipation and confusion.

These side effects can be especially troubling for patients who are taking medications for other conditions. Many patients stop taking their medications because of the side effects or need additional prescriptions to manage their side effects.

In recent years, OnabotulinumtoxinA, commonly known as Botox, has been studied and approved as an alternative treatment for overactive bladder in certain patients with urge incontinence when another type of medicine does not work well enough or cannot be taken.

Botox is a protein from the bacteria that cause botulism. Small doses of Botox injected directly into bladder tissue works by relaxing the bladder muscle, therefore reducing the urge to urinate. Botox injections are done via a simple, outpatient procedure performed by a gynecologist or urologist.

The treatment usually takes about 20 to 30 minutes and is followed by 30 minutes of observation.

In a study published in the New England Journal of Medicine, in nearly 250 women who had urge incontinence, a one-time Botox injection in the bladder worked as well as daily pills at reducing episodes of urinary incontinence at six months.

Dr. Magdalene Karon, is an obstetrician and gynecologist practicing at Saint Joseph East, part of KentuckyOne Health.

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