Bladder Botox
Bladder Botox
Botox injected into the bladder is well tolerated, and the most common side effect is a urinary tract infection.
What Is Botox?
Botox (botulinum toxin type A) is a medication that temporarily paralyzes muscles when injected locally. Botox is generally known for its cosmetic uses, but it can actually help with a number of medical conditions. Botox is a neurotoxin derived from the bacterium Clostridium botulinum. This bacterium can be found in many natural environments, including lakes, soil, and forests.Botox is a treatment approved by the U.S. Food and Drug Administration (FDA) for overactive bladder, urinary incontinence, and spastic bladder caused by neurological disorders. Botox temporarily paralyzes the bladder muscle, and its effects last for about 6 months.
If not used properly, it can be a highly toxic substance. When injected into humans in small concentrations, it can prevent signals from nerve cells from reaching the muscles.
For muscles to contract, nerves must release acetylcholine—a chemical messenger—at the point where nerve endings meet muscle cells. Botox prevents muscle contraction by blocking the release of acetylcholine.
How Can Botox Injections Treat an Overactive Bladder or Incontinence?
In 2013, the FDA approved the use of Botox for the treatment of overactive bladder (OAB). This approval expanded upon the previous approval for the use of this treatment option for urinary incontinence and severe spastic bladder conditions resulting from neurological disorders such as multiple sclerosis or Parkinson’s disease.
Botox works by relaxing the nerves to help block the signals that trigger an overactive bladder or incontinence. It should not be the first-line treatment, but it can be a good option for both men and women before surgery.
Botox Treatment Procedure
Before Botox treatment, a test will be performed to ensure the patient does not have a urinary tract infection. If one is present, the treatment will be rescheduled.
The doctor performs a cystoscopy by inserting a cystoscope into the urethra, which is the opening through which urine exits the body. Botox is administered via the cystoscope through a series of rapid injections into specific areas of the patient’s bladder muscle.
It may take 24–72 hours for the Botox to take effect, though in rare cases it may take longer.
About 6 out of every 100 patients require a catheter after treatment. If this is necessary, the doctor will explain the catheterization process before treatment. This catheter is smaller than those used in hospitals and can be easily concealed.
Side Effects
Botox injections are generally well tolerated, but patients may experience a burning or stinging sensation during the first few times they urinate. Patients may also notice blood in their urine immediately after treatment.
The most common side effect of using Botox to treat overactive bladder or incontinence is a urinary tract infection. Other side effects include fatigue, painful or difficult urination, and temporary inability to empty the bladder (urinary retention).
Frequency of Injections
The effects of Botox last about 6 months, and it needs to be re-injected when the patient notices that the benefits are diminishing. Patients should wait at least three months between treatments, but there is no limit to the number of times this treatment can be used.
A Comparison of Bladder Botox with Similar Treatments
Botox may offer many benefits for an overactive bladder or incontinence. It can be an ideal treatment for people of all ages. For elderly patients, this treatment may be preferred over surgery because it causes less harm to the body.
The cost of Botox injections for the bladder is comparable to that of oral medications, sacral neuromodulation (SNM), or percutaneous tibial nerve stimulation (PTNS), which are covered by most insurance plans.
Oral medications: Botoxinjections reduce the need for patients to take a pill every day. The downside of Botox injections is that patients must visit their doctor about once every 6 months to receive new injections.
Nerve stimulation: SNMand PTNS are two types of nerve stimulation therapy. These treatments use electrical stimulation of the sacral nerve, which can alter bladder and bowel function.
One advantage of SNM treatment over Botox is that it requires a time commitment upfront and does not require extensive follow-up care.
Botox requires a shorter time commitment than PTNS, as PTNS patients initially require 12 weeks of treatment.