Botox to Fix a Voiding Problem: April 25, 2013

It’s a new wrinkle in the use of Botox: instead of filling a void in the face, it’s now approved to fix a voiding problem - overactive bladder.

“Well Botox has been used for a long time for spasticity; there has been indications for muscle rigidity,” says Dr. Harold Tsai, urologist on Lee Memorial Health System’s medical staff.

A neurotoxin, Botox stops chemical transmission to specific nerve endings, causing temporary muscle paralysis.

“The muscle is called the detrusor muscle. And a lot of times the detrusor muscle is out of sync with the brain and is sending signals toward the bladder. So that will paralyze the muscle that’s overreacting,” says Dr. Tsai.

When the FDA approved Botox for bladder dysfunction, it aimed for patients who tried and failed with medications. A more invasive approach, it’s given by injection in the doctor’s office.

“There’s a scope that’s placed into their bladder, males and females both, and then we anesthetize the muscle of their bladder with numbing agent. And then we inject it with a very small injections, systematically in the muscle of the bladder,” says Dr. Tsai.

Injections wear off over time, but should give patients up to 10 months of relief from racing to the bathroom.

“We know it’s not going to solve their problem. Our hope is that it decreases frequency, urgency therefore the act of the leakage,” says Dr. Tsai.

This isn’t Botox’s first stab at non-cosmetic usage. It’s also FDA approved for migraine headaches and excessive sweating.