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Healthy Living Blog

Botox for Incontinence: When to Ask Your Doctor for Advice

February 16, 2017 | Dr. Patrick Waters


When you have to go, you have to go, right? But how do you know when you have to go so frequently that it might be time to go to the doctor?

Overactive bladder affects millions of Americans. Although it is common among older adults, it isn’t a normal part of aging that you simply have to accept.Botox for OAB

When someone invites you to a football game, do you immediately begin to fret about how long the lines will be for the restroom? Do you only buy theater tickets that are on the aisle so that you can escape quickly if the urge hits? Could you write a travel guide detailing every stop on the Ohio Turnpike—because you never make it more than an hour without stopping?

It may be annoying, but it also may be time to see a doctor if you experience the following symptoms on a daily basis.

• A sudden urge to urinate that is hard to control

• The involuntary loss of urine immediately following an urgent need to urinate

• Urinating eight or more times in 24 hours

• Waking up more than two times a night to urinate

The good news is that there are several treatments for overactive bladder, ranging from behavioral modifications to sacral new modalities. Prescription drugs (including anticholinergics and B-3 agonists that work by blocking abnormal bladder contractions). The bad news is these treatments don’t always work for everyone, or they can cause bothersome side effects.

That’s why it was so exciting when, in 2013, the U.S. Food and Drug Administration approved Botox for incontinence as a new treatment option for those who do not respond to medications. The drug that can make you look better can also help many people to gain bladder control.

Botox can be injected directly into bladder tissue, causing the bladder to relax, which increases the bladder’s storage capacity and reduces episodes of urinary urge incontinence. The injection is done through a scope in the bladder that allows a doctor to visualize the interior of the bladder while Botox is being injected.

Two research studies showed promising results. In the first study, roughly nine in 10 patients saw a 50 percent or greater drop in daily urinary urge incontinence episodes. Between 44 percent and 52 percent of patients saw all urge incontinence episodes subside.

The second study found that long-term Botox treatment produced a consistent drop in daily incontinence episodes, with one injection producing stable results for an excess of one year among a third of patients.

The most common side effects of the treatment include urinary tract infections (UTI) and incomplete emptying of the bladder (urinary retention). In the clinical trials for Botox, UTI occurred in 24 percent of patients who got the Botox treatment, compared to 17 percent of patients who took a placebo. Urinary retention affected 17 percent of patients who were treated with Botox, compared to 3 percent who were treated with a placebo. Severe side effects from Botox in the bladder are extremely rare.

So with all of the treatments available for urinary urge incontinence, how do you know which one is best for you?

Ask your doctor these questions:

1. What’s the most likely cause of my symptoms?

2. Can I do things at home to relieve symptoms of overactive bladder?

3. Is my urinary incontinence temporary?

4. I have other health concerns. How can I best manage these conditions together?

5. Can menopause cause overactive bladder among women?

6. Is Botox for urinary urge incontinence a good option for me?

7. How common are the side effects of Botox for urinary incontinence and how are they treated?

8. What other treatments or behavior modifications should I try?

There are many effective ways to treat urinary urge incontinence. We can help you develop a strategy to take control of this common condition and, by doing so, improve your quality of life. Contact us to schedule an appointment with Dr. Patrick Waters at 419-627-8771.

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