Botox has for a long time been used to smooth wrinkles and aging skin. However, new research indicates that the muscle relaxant can also be used to treat urinary incontinence. Botox, or botulinum toxin, is used to relax muscular tissues. For individuals suffering from a strong urge to urinate, Botox can significantly relax the bladder and ease such symptoms. This reduces the need to pass urine as frequently as the patient did before. While it is a well-tolerated procedure, it has to be repeated every four to nine months.
Urinary incontinence is a condition whereby an overactive bladder contracts without warning or too often. This leads to the constant urge to urinate, and also the likelihood of bladder leakage. Individuals who rush to the bathroom to pass urine, or those who do it too often, are suitable for Botox. First, a test known as urodynamics is performed to find out whether the bladder muscle contracts wrongly when the bladder is supposed to be storing urine.
If the test shows that the bladder is contracting inappropriately, some drugs are tried first in order to calm the bladder muscles. Such drugs are called anticholinergic drugs and include solifenacin, tolterodine and oxybutnin. Should the medications fail to work, then there is need to know whether the bladder’s physical size has been reduced. This can be done by filling up the bladder up under a short general anesthetic to find out how much it can hold. No incisions or cuts are made when this is done. In case the bladder is found to be of normal size, then Botox can be administered. If not, then an operation is recommended in order to enlarge the bladder.
Administration of Botox is a day case procedure, meaning that patient is admitted to a ward on the day it is administered. The patient is not supposed to eat or drink anything five hours before the procedure. Botox can be administered either when the patient is asleep or with the bladder being made numb. Under a general anesthetic, the bladder undergoes a telescope examination. The telescope is passed via natural passage ways in the bladder, meaning no incisions are made. The bladder undergoes a careful examination. Botox is then injected into the bladder using a special needle directly passed through a telescope. Afterwards, the bladder is emptied. In some cases, a catheter is used to empty the bladder.
A patient can eat or drink shortly after being administered with Botox, and can be allowed to go home that same day. The patient should notice a reduction in the frequency and urgency of visiting the bathroom to pass urine about five days after the Botox has been administered. Should some leakage have occurred before the administration, no leakages should be observed afterwards. The maximum benefits are observed about two weeks after the Botox has been administered, with the total effect lasting for between four and nine months.
There have been a few reported side effects of Botox. Blood may be observed in the urine after Botox is administered, given that the needle penetrates the bladder’s wall. This blood may appear for a few days, but there should be no cause for alarm since this will wear off after some time. An infection is likely to develop in the urine, but this can be avoided by administration of antibiotics. Some patients describe a difficulty in emptying the bladder completely. In some of such patients, passing a catheter intermittently (ISC) may be necessary. Most of them will tolerate this and will not be needed for more than a few weeks.
Allergic reactions are sometimes reported, although on very rare cases. Also, on very rare occasions, breathing may stop if Botox is directly injected into a blood vessel. Such an effect would not take place immediately, but is noticeable gradually over a period of a few weeks but with some time to act. The right treatment is then administered. Given that Botox weakens the bladder muscle, it is advisable for patients to learn how to pass a specifically designed catheter before Botox is administered. This is because the bladder may temporarily fail to empty completely. A catheter may be the easiest to empty the bladder. The good news is that it will not be needed forever as Botox wears off after between 4 to nine months.