Botox for the Bladder?

It is well known that Botox or botulinum toxin is used to smooth the wrinkles on the aging face.  But not many know that Botox is also a useful tool in the treatment of overactive bladder, a condition affecting millions of men and women which causes frequent, urgent urination associated with leakage of urine or urinary incontinence.

Overactive bladder is most commonly treated with medications designed to improve bladder control.  However, these medications are not always effective and they frequently have side effects that make them intolerable.  Botox works by simply paralyzing muscles.  When injected into the face, it can relax the tiny muscles that cause the small creases in the skin.  When injected into the bladder muscle, it can relax the bladder spasticity that patients with overactive bladder often have.  The end result is less frequent urination with impressive improvements in bladder control.

A recent study published in the New England Journal of Medicine compared Botox injections into the bladder with typical medications used for the treatment of overactive bladder.  The authors found that the patients undergoing Botox injections had higher rates of complete continence than the patients taking medications.  There was a similar reduction in urinary frequency between the two groups.  Though a small percentage of patients undergoing Botox injections required catheter drainage for bladder emptying and some patients developed transient urinary tract infections, the side effects of Botox injections overall were well tolerated.

Dr. Debra Fromer is the Chief of Female Pelvic Medicine and Reconstructive Surgery in the Department of Urology at Hackensack University Medical Center.