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Botox & Your Bladder: June 15, 2014

It’s a new wrinkle one the use of Botox- based on success in nerve related bladder control, researchers find it may replace surgery in difficult cases.

“The first line therapy for overactive bladder is medication. There’s a second and third line treatment. This is going to compete with some of those,” says urologist Dr. Harold Tsai. He is on the medical staff at Lee Memorial Health System.

It stems from the same wrinkle-smoothing affect that paralyzes facial muscles. Doctors believe Botox works in two ways: by blocking the sensory effects from the brain which tells the body it has to go- and blocking the nerve endings responsible for bladder contractions.

“It’s a neurotoxin and basically it causes paralysis of the muscle,” says Dr. Tsai. “There’s a chemical that’s released by the nerve ending and this prevents the chemical from being released. Therefore, the nerve cannot conduct the transmission of the nerve signal.”

Currently performed as an inpatient procedure— the Botox is delivered directly into the bladder. Man or woman, doctors insert a scope through the urethra, numb the bladder and administer a series of shots.

“We just place the needle into the muscle and we inject equal amount of Botox throughout the bladder. The total is what we call 200 units of Botox,” says Dr. Tsai

Studies are now looking at replacing injections with one infusion - either way - the Botox should iron out their problem.

“We hope to decrease the frequency, urgency, accidents and also increase the bladder capacity that’s our hope. So we hope the patients improve in one, all, or some of these symptoms.”

As in all uses of Botox, the effect is temporary and needs repeating.