Botox May Treat Urinary Incontinence

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July 30, 2004 (San Diego) -- Researchers say injections of Botox may help people with urge incontinence, a condition in which the bladder contracts and squeezes out urine involuntarily. Botox injections reduce muscle contractions that cause the sudden, undeniable need to urinate felt in urge incontinence.

In a Swiss study presented at the joint meeting of the American Urogynecologic Society and the Society of Gynecologic Surgeons, researchers show that Botox was effective in reducing uncontrolled urination.

"This therapy seems to be safe and effective in treating urge incontinence," says researcher Bernhard Schuessler, MD, from the department of obstetrics and gynecology at the Cantonal Hospital in Lucerne, Switzerland. "This is one of the first pilot studies showing that injections of this agent" offer at least short-term relief.

Patients in the study had not responded to the medications typically used to treat urge incontinence, such as those that reduce spasms and relax bladder muscles.

Few 'Bothersome' Symptoms

The study involved 26 patients whose average age was 66. They all had urge incontinence that was resistant to treatment medications, and they reported that incontinence affected the quality of their life. The patients kept a diary and recorded how frequently they urinated and quality-of-life factors.

The patients received injections of Botox into a bladder muscle and were followed for four, 12, and 36 weeks after treatment.

The study showed that treatment with Botox resulted in a significant increase in the amount of urine the bladder could hold, a term known as maximum bladder capacity, which resulted in an ability to delay going to the bathroom when the first need to void was felt. Daytime bathroom trips decreased from an average of 12 to four. No patients were incontinent. Two patients required self-catheterization for one week after treatment because their bladders were not completely emptying.

The questionnaire evaluated patients' perceptions of the bothersome nature of their symptoms. At the start of the study, most reported their symptoms to be moderately or severely bothersome. Four weeks after treatment, most patients said their symptoms were "no bother at all" or "a little bother." Five patients considered their symptoms a "moderate bother," and no patients reported that they were extremely bothersome.

After the initial effects of treatment diminished, two patients received repeat injections, at five and 10 months after the initial treatment, respectively. Among the patients, all said they would be willing to undergo repeat injections.

Although these initial findings are impressive, the standard medications should be used first, says Linda Brubaker, MD. She was not involved in the study.

"Injections of botulinum toxin are a novel new therapy for urge incontinence," she tells WebMD. "They appear to help certain people who haven't responded to standard therapy, but the findings of this study should only be applicable to a small group of people."

Brubaker is professor of obstetrics-gynecology and urology at Loyola University Medical Center in Chicago.

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