Bladder Problems? - Go For Botox

By Margarita Nahapetyan

Botulinum toxin, or Botox, better known as the treatment for smoothing and reducing wrinkles and fine lines, may also help people with an overactive bladder that causes urinary incontinence, according to a new research.

According to the report, doctors have found that an injection of Botox directly into the bladder wall can improve symptoms in individuals over 50 years of age, reducing incontinence and making a "significant" impact on their life quality for up to 6 months. Those who had been administered the injection, reported to sleeping better, having more energy as well as they could go out more and become involved in relationships.

The findings are based on a randomized trial that was conducted between May 2004 and February 2006. Dr. Arun Sahai and a team of scientists at Guy's Hospital and King's College in London, involved 34 male and female participants with an average age of 50 years, who suffered idiopathic detrusor overactivity (IDO), a form of overactive bladder (OAB). This condition is characterized by occasional loss of bladder control (incontinence) and is generally treated with bladder training, anticholinergic drugs and, most importantly, with lifestyle modification. For the study pusposes, researchers used data from a previous 2007 trial that reported the bladder measurements.

To be able to participate in the study, the participants must not have been taking anticholinergic therapy before the trial, either because of the side effects produced by these drugs or because the drugs had not worked when previously taken. The investigators randomly assigned 16 of the patients to receive 200U of Botox-A shots and the remaining 18 to receive a placebo injection of salt water. The injections were administered by means of a flexible cystoscope, a procedure that involves minimal invasion, in which 20 separate doses of 10U of Botox-A were injected at various spots in the bladder. All the subjects were discharged on the same day, providing they felt well enough, and were allowed to use anticholinergic medication at any time during the experiment.

Throughout the study, all the participants were asked to fill out three questionnaires and report on their quality of life, once at the very start of the study and then at four, 12 and 24 weeks after the Botox injections. When analyzing the results and using these questionnaires, the investigators revealed that, overall, people's quality of life has improved. Individuals who received Botox shots, were compared to those in a group who had placebo, or salt water injections.

Specifically, the experts found that subjects who had been administered botulinum toxin injections, reported that:

• Their bladder problem had less effect on their lives.

• They were less likely to limit their activities because of incontinence.

• They felt much happier.

owever, it is important to note that the treatment did not completely solve the problem of incontinence.

"Our study showed a significant relationship between the overall improvement in OAB symptoms and improved quality of life scores," the experts said. They explained that at 4 weeks urgency and urge urinary incontinence were statistically correlated with improvements in quality of life and the same was true at 12 weeks for frequency and urgency. The overall benefits lasted at least up to 6 months after the shots were given, with people reporting both a reduction in problematic bladder symptoms and an improved quality of life.

Botox, which is derived from botulinum toxin, works by interfering with nerve signals in the treated muscle, essentially paralyzing it. Injected to the muscles of the bladder, the chemical is believed to prevent or reduce the spasms that are associated with the symptoms of overactive bladder - a strong, frequent urge to urinate, sometimes even accompanied by some leakage.

The findings are published in the journal BJU International.