People frequently have botox injected for cosmetic use. In 2002, it was deemed fit to improve the look of facial wrinkles and it has risen in popularity ever since.
This popularity rise is evident in both men and women. Patrick Bowler, medical director of the Courthouse Clinics in the UK asserts, “from 2011 to 2013, men having botox rose over 200 percent in my clinics and the number continues to rise”. However, it may come as a surprise to you that the toxin has been proven to be successful in treating many muscular disorders. Botox for incontinence has been shown to be successful in improving symptoms. Injecting botox into the wall of the bladder can have a long-lasting impact on reducing leakage frequency. In individuals with urinary incontinence, the bladder muscle often squeezes at an inappropriate time, which results in an urge to pass urine. Botox aims to reduce unwanted bladder contractions due to this urge, allowing patients to control their bladders better. Botox procedures are particularly successful in treating urge incontinence.
Are you unsure what the ideal treatment method is for your incontinence? Read our living with incontinence section for advice on treatment and lifestyle tips.
What is Botox?
Botox is the trade name for Botulinum A Toxin. It is derived from Clostridium Botulinum, an organism that is found in the natural environment where it is largely inactive and non-toxic. The toxin can be injected into people in extremely small concentrations. It has been shown to improve incontinence by preventing signals from the nerve cells reaching muscles, paralysing them. Botox injections can be performed with a general anaesthetic or a local anaesthetic. The procedure is carried out under local anaesthetic and lasts 30 minutes on average. During the procedure, a small telescope is passed into your bladder through your urethra, the tube that carries urine from the bladder to outside the body. Between 10 and 20 injections of Botox are injected into your bladder wall to reduce uncontrolled contractions.
The surprising success of injecting Botox for incontinence has been confirmed in many studies over the years. Data was initially limited due to professionals being hesitant of a successful outcome, however, several trials have been published in the last 3 years to prove otherwise. One study in 2005 investigated the effect of botox injections into the detrusor and external sphincter muscle in patients with incontinence. 41 women and 3 men were included in the study. 200-300 U of botox was injected into the detrusor and external sphincter muscle. The patient’s progress was tracked through a bladder diary, urodynamic examination and a questionnaire. As a result of the procedure, patients’ average pad use decreased from 4.2 pads per day to at most 2.4 pads per day after 6 months. The efficacy of Botox in patients with Parkinson’s disease has also been confirmed to be particularly successful in many recent studies. Dr Hammadeh is a Surgeon who has had a great deal of success using Botox. He remembers one patient saying, “absolutely brilliant- I am able to go on holiday and wear a swimsuit with no worries”.
When is Botox recommended?
Incontinent individuals are primarily recommended to seek conservative measures. These often include significant lifestyle changes, caffeine intake reduction, pelvic floor exercises and bladder training. Botox should be considered as an option of surgery when less invasive methods have been unsuccessful. It is also suggested when anti-cholinergic tablets have been unsuccessful. Men and women who report having to pass urine frequently or rush to the toilet to pass urine are suitable for Botox. Before recommending Botox, a urodynamics test is performed to determine whether the bladder muscle contracts inappropriately. Doctors do not allow you to go forward with Botox if you have a urinary tract infection or cannot empty your bladder on your own.
What to Expect After Surgery: The Benefits and Risks
Botox can take up to 2 weeks to take effect, however, it is estimated that 70-80% of patients will notice an improvement in their symptoms after their first treatment. Botox treatments usually last between 3 and 9 months before the symptoms return. When this occurs, the surgery may be repeated. On some occasions, Botox can cause loss of strength or muscle weakness. It can also often cause vision problems or dizziness. Some people can also find it difficult to fully empty their bladder. If this occurs, you can talk to your GP about inserting a catheter into your urethra to help drain the urine.
In many cases, the procedure is a safe and efficient solution to improving incontinence. In general, the average person can expect a 60 percent reduction in leakage rate, a 50 percent reduction in urgency, and a 70 percent improvement or success rate. Richard Parkinson is a surgeon who performs all bladder botox injections at Nottingham City Hospital. Parkinson has published two articles in the last two years on the use of Botox for incontinence. He asserts, “the success rate in Nottingham is 89% with beneficial effects lasting on average for 10 months”. If you do have the procedure and find it to be ineffective, you can switch urologists and have a second attempt.
Key Points to remember about Botox for Incontinence:
- The treatment reduces symptoms, however, is not permanent
- Treatments normally last between 3 and 9 months before symptoms return
- You can have repeat injections when needed
- It has a 70 percent improvement rate
- It does not improve bowel function
- You should be aware of the potential side effects
- Do not have Botox if you have a urinary tract infection or cannot empty your bladder on your own