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Botox for Incontinence? Fisher-Titus Offers This Latest Treatment

July 14, 2016 | Dr. Patrick Waters


botox-for-incontinenceFisher-Titus is proud to announce its partnership with Executive Urology Specialists. The board-certified team has been providing comprehensive urologic care to the north-central Ohio area for over three decades. Fisher-Titus welcomes Dr. Gregory P. Cook, MD, Dr. Robert Rice, MD, Dr. Donald Smith, MD, and Dr. Patrick Waters, MD, to our growing family of physicians.

Expanding our team means more options for urologic services, including the latest surgical and nonsurgical solutions for both men and women. One of the newest urologic services to be offered at Fisher-Titus is using Botox as a treatment for urgency and urge incontinence. Here is what patients considering this procedure need to know before they talk to their doctor.

What is Urinary Incontinence?

Urinary incontinence is a symptom, not a disease. It is the result of the brain and bladder’s inability to communicate correctly when the bladder is full and needs to be emptied. There are four types of urinary incontinence:

1. Stress Urinary Incontinence (SUI)

More common in women, this type is caused by weak pelvic floor muscles that leak urine when put under pressure through physical activity.

2. Overactive Bladder (OAB)

In this type, either the brain tells the bladder it must be emptied even when it isn’t full, or the bladder muscles contract to release urine before it becomes full, creating the sense of urgency that you need to urinate immediately. It is more common in older adults.

3. Mixed Incontinence (a combination of SUI and OAB)

This occurs when an individual leaks with physical activity but also experiences frequent urges to urinate even when not physically active.

4. Overflow Incontinence

The body generates more urine than can be held in the bladder, or the bladder becomes full but cannot fully empty. This causes urine to leak or have a constant drip. This could mean there is a blockage or the bladder muscle is unable to contract properly. It is rare in women and mostly affects men with prostate problems.

Overactive Bladder and Neurological Disease Link

More than 2.5 million men and women suffer from an overactive bladder due to a neurologic condition such as stroke, multiple sclerosis or Parkinson’s. These types of conditions interfere with the messages being sent between the bladder and the brain, causing the brain to miscommunicate the urge to urinate, which leads to urine leaking beyond one’s control.

How Does Botox Help?

urinary-incontinence-treatmentFor patients experiencing overactive bladder issues, the first method of treatment is likely to be anticholinergic or B-3 agonist medication. These are prescribed to help regulate the feelings of urgency and frequency. If these medicines are not effective, or if patients cannot handle the side effects, doctors may prescribe Botox to help reduce bladder contractions.

Botox can help reduce leaking episodes by increasing how much urine the bladder can hold and decreasing the amount of pressure in the bladder by paralyzing the bladder. It can be done in your doctor’s office and requires no down time. To be treated with Botox, you will be numbed before it is injected into the bladder muscle. The procedure takes roughly 15 minutes and you will be observed by your doctor for 30 minutes immediately following the procedure to make sure your bladder is completely emptied and there are no complications. The treatment should last anywhere from six to 10 months. Talk to your doctor about repeating treatment no sooner than 12 weeks from the first procedure.

Side Effects

There shouldn’t be much pain following the injections, but stinging and burning sensations may occur the first few times. Discuss with your doctor any medications you are currently taking and the dosages, and disclose all medical conditions you have so your doctor can determine how they might interact with Botox. Seek immediate medical attention if you experience any of the following:

  • Problems swallowing, speaking or breathing
  • Spread of toxin effects: the effects of Botox could potentially affect areas not close to the injection sites, resulting in serious side effects such as muscle weakness, double or blurred vision or change or loss of voice.

Other side effects include dry mouth, discomfort at the injection site, fatigue, headache and eye-related issues such as drooping eyelids or swelling of the eyelids. The most common side effects experienced in the first 12 weeks after injection include urinary tract infection (UTI), urinary retention (the inability to fully empty the bladder, which may require the use of a catheter) and hematuria (blood in the urine).


Patients should expect a decrease in incontinence occurrences as early as two weeks after the procedure. While Botox for incontinence is not a cure, some patients may see all incontinence episodes stop, though this is rare. Most will see a large decrease in the number of episodes.

To find out if Botox is the right urinary incontinence treatment for you, get more information here.

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