“I’m so relaxed right now.” —your bladder muscles on Botox
If you’ve tried to ease your overactive bladder symptoms with lifestyle changes and medications and nothing seems to work, don’t give up hope. “If a patient has tried medications and they’re not working, or refuses to try medications and wants to skip that and go to something else, what’s usually offered next is Botox injections,” says Lauri Romanzi, MD, a urogynecologist in New York City.
What Is Botox?
“Botox was originally discovered as a toxin that’s derived from bacterium called Clostridium botulinum,” says Kaveh Alizadeh, MD, a plastic and reconstructive surgeon in New York City. This toxin is actually the same one that causes a life-threatening type of food poisoning called botulism, but doctors use it (completely safely) in small doses to treat health problems, like to reduce wrinkles, treat uncontrollable blinking (blepharospasm), or in this case, overactive bladder.
Botox injections work by weakening or paralyzing certain muscles or by blocking certain nerves that make your bladder cranky. Its effects last about three to twelve months, depending on what you are treating.
How Botox Helps Treat Overactive Bladder
Botox’s muscle-relaxant effect allows it to be very effective for overactive bladder symptoms, says Dr. Alizadeh. “[With overactive bladder] you have spasm of the muscle that surrounds the bladder, and by injecting [Botox] around it you’re able to take away the spasm that causes the overflow of the bladder,” he says.
During the procedure, a doctor will insert a small fiber-optic tube through the urethra into the bladder. A tiny needle is then inserted into the tube and the Botox is injected at different points in the bladder. “Once it’s in, as with any other part of the body, it relaxes the muscle, and this can help reduce overactive bladder symptoms,” says Dr. Romanzi.
A risk with getting Botox injections to treat overactive bladder is that your bladder may overreact to the drug, which may make it difficult to pee. “It can be a little bit distressing initially if it happens to you,” says Dr. Romanzi. “But, it almost always goes away over time.”
Getting treated with Botox requires ongoing sessions; one treatment isn’t going to cure overactive bladder. “You need to go back at some sort of interval that works for you, and is safe according to the doctor,” says Dr. Romanzi.
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If a patient has tried medications and
they're not working or
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refuses to try medications and wants
to skip that and go to something else,
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what's usually offered
next is Botox injections.
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Botox injections help relax muscle.
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00:00:22,084 --> 00:00:26,969
Botox was originally discovered as
a toxin that is derived from a bacterium
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00:00:28,820 --> 00:00:33,320
It got its first use on blepharospasm by
ophthalmologists, and that's a condition
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where the muscles are constantly
under spasm and there's no control.
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So the eye doctors were using
it to help relax the muscle.
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The mechanism of action of Botox also
allows it to be very effective for
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the overactive bladder.
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Because in that condition, you have spasm
of the muscle that surrounds the bladder.
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And by injecting it around there
you're able to take away the spasm
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that causes the overflow of the bladder.
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A small fiber optic tube is inserted
through the urethra into the bladder.
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And then, through this tube,
a very tiny needle is inserted and
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the Botox is injected at
different points in the bladder.
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Once it's in, as with any other part
of the body, it relaxes the muscle.
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And this can help reduce
overactive bladder symptoms.
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You need those injections done at
intervals, one Botox injection is not
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gonna fix it you need to go back at some
sort of interval that works for you and
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is safe according to the doctor.
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One of the risk of Botox injections
can be a transient difficulty emptying
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your bladder if your bladder
overreacts to the Botox.
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But this almost always
goes away over time.
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It can be a little bit distressing
initially if it happens to you.
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Severe overactive bladder
usually needs medications, and
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severe overactive bladder that doesn't
respond to medication usually needs Botox
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or a neuromodulation bladder pacemaker.
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The earlier you come in,
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the more likely you are to be able to
avoid those more extreme therapies.
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Use of botulinum toxin for treatment of non-neurogenic lower urinary tract conditions. Chatham, MA. UpToDate, 2021. (Accessed on April 14, 2021 at https://www.uptodate.com/contents/use-of-botulinum-toxin-for-treatment-of-non-neurogenic-lower-urinary-tract-conditions)Botox. Bethesda, MD. U.S. Department of Health and Human Services, MedlinePlus. (Accessed on April 14, 2021 at https://medlineplus.gov/botox.html)