Botox can be a good option before surgery for both men and women and can be the ideal treatment for older patients with a neurogenic bladder.
Botulinum neurotoxin (BoNT) or Botox is well-tolerated and effective in treating certain muscular conditions, such as the overactive bladder (OAB), urinary incontinence (unintentional and involuntary passage of urine), and spastic bladders caused by neurologic diseases, such as multiple sclerosis or spinal cord injury.
Botox is used in other conditions, such as:
- Cosmetically to remove wrinkles
- Cervical dystonia (neck spasms)
- Hyperhidrosis (excessive sweating)
- Chronic migraines
- Lazy eye
- Eye twitches
6 benefits of Botox in the neurogenic bladder
Urinary incontinence is a common condition and can potentially impair social, physical, and mental well-being.
Approximately 17 percent of women and 3 to 11 percent of men suffer from urge incontinence at some point in their lives.
- Preferable treatment before surgery
- Reduces the discomfort of taking a pill every day
- Relief of symptoms for at least six months (prolonged effect)
- Long duration of action
- An alternative to anticholinergic and ant muscarinic medications
- Improves quality of life
What is Botox?
Botox is a drug prepared from botulinum A toxin, which is derived from a bacterium called Clostridium botulinum and is responsible for causing botulism (a type of food poisoning).
This bacterium is mostly found in lakes, soils, and forests, the intestinal tracts of fish and mammals, and the organs and gills of crabs and shellfish.
Botox is safe when used in small amounts for medical purposes.
How does Botox work?
Botox treatment decreases incontinence and improves the quality of life.
Botox works by:
- Temporarily paralyzing the bladder muscle
- Preventing signals from the nerve cells from reaching the muscles
- Prevents the release of acetylcholine (a chemical messenger), thus preventing muscle contractions
- Calm the nerves by blocking the signals that trigger incontinence
- Increases bladder capacity
- Decreases detrusor (a type of muscle in the urinary bladder) pressure
What is Botox used for?
Botox is a U.S. Food and Drug Administration-approved treatment for:
- Urinary incontinence due to aging
- Overactive bladder
- Spastic neuropathic bladder from neurological diseases, such as multiple sclerosis and Parkinson’s disease
- Spinal cord injury with neurogenic detrusor overactivity
How is Botox treatment done?
One day before Botox treatment, an antibiotic is administered to reduce the risk of urinary tract infection (UTI).
Botox is administered under general anesthesia or sedation and after performing a cystoscopy, wherein a cystoscope is inserted into the bladder through the urethra.
An intradetrusor (into the bladder muscle) injection of Botox is administered in small concentrations through the cystoscope, which can take up to 24 to 72 hours to be effective.
The effects last for approximately six months, after which re-injection is needed.Botox injection is not recommended for males with a history of enlarged prostate.
6 side effects of Botox injections
For most people, Botox is well-tolerated.
Other than short-term discomfort, the most reported side effects include:
- Urinary tract infection
- Pain while passing the urine
- Difficulty urinating
- Urinary retention
- Hematuria (blood in the urine)
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University of Utah Health. Bladder Botox. https://healthcare.utah.edu/urology/services/botox.php
Weckx F, Tutolo M, De Ridder D, Van der Aa F. The role of botulinum toxin A in treating neurogenic bladder. Transl Androl Urol. 2016;5(1):63-71. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4739988/
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