Botox injections are most noted for their use in cosmetic procedures. However, the same type of drug that can reduce facial wrinkles can also help fight against incontinence in women.
Botox, which is prepared from the bacterial toxin botulin, can prevent certain chemical signals from reaching nerves, mostly signals used to contract muscles. This essentially paralyzes muscle activity temporarily. The resulting effect can address bladder muscle problems that lead to leakage.
A similar injection-based treatment for overactive bladder involves using a bulking agent. In this procedure, the doctor uses a gel-like substance such as Coaptite or Macroplastique. The material is injected into the urethra, which is the tube that carries urine from the bladder. With this bulking agent, the urethra can tighten and more easily stop leaking.
Stress urinary incontinence and overactive bladder are common conditions for women. In fact, they impact roughly 33 million people in the United States. Causes range from frequent pregnancies and being overweight to spinal cord injuries and hereditary genetics. Symptoms of overactive bladder include going to the bathroom more than eight times a day as well as a frequent sudden urge to urinate. While some sufferers may assume that these symptoms are a natural part of aging, there are many treatments available.
Urology doctors often start patients with behavior modifications such as dietary changes and bladder retraining. From there, pelvic exercises and/or oral medication may be prescribed. If these treatments fail, however, Botox or bulking agent injections can provide a minimally invasive solution for patients. These procedures are best for women who want to have children, are not healthy enough for invasive treatments, or do not wish to undergo surgery.
The Injection Procedure
To inject intravesical Botox, the doctor completes a flexible cystoscopy procedure. This involves inserting a flexible thin tube with a camera into the urethra until it reaches the bladder. A local anesthetic is applied to reduce any pain. Once the camera passes through the sphincter, the doctor will be able to see the bladder lining. Sterile water is generally pushed through to expand the bladder and provide a better view. The doctor will then administer roughly 20 tiny Botox Type-A injections into the bladder’s muscle tissue. From start to finish, the entire procedure takes about 15 minutes.
Injecting bulking agents involves a similar flexible cystoscopy with a local anesthetic to lower pain and an antibiotic to reduce the risk of infection. However, the doctor will only advance as far as the urethra or sphincter for the injections. Using a cystoscope, the physician will inject the bulking agent directly into the urethra tissue. The procedure takes approximately 30 minutes.
Both intravesical Botox and bulking agent injections are temporary solutions for overactive bladder issues. In the case of Botox, the results could last up to 12 months. Roughly 60 to 70 percent of patients will need repeat treatment. As for blocking agents, about 65 percent of women will notice a cure or improvement of their bladder symptoms. However, a second injection is often required as the bulking effects diminish with time.