Detrusor muscle local anesthetic and as a day patient
Fifty-six-year-old Carol Ronse used to need the toilet at least 20 times a day. In fact, her urge to urinate was so great that it was seemingly taking over her life - and no treatment seemed to work.
The Carol tried Botox injections - not on her face, but directly into her bladder.
"The whole procedure, carried out under local anesthetic and as a day patient, was uncomfortable - rather like pinching but inside my tummy - yet not painful. The procedure lasted around 20 minutes and afterwards I felt no pain at all and went home," she told the British Daily Mail newspaper.
"After around nine months the effects did start to wear off and I went back for a second injection. I will need to have these 'top-ups' indefinitely. Still the change to my life is immeasurable. Quite simply, after 20 years of problems, at last I feel normal."
Most of us associate Botox with getting rid of frown lines and wrinkles. Now the versatile Botulinum toxin, which can cause severe food poisoning, has yet another purpose besides making us appear younger than we actually are: it is increasingly being used to treat urinary incontinence.
Botox for the Bladder
Botox, which is most commonly used in cosmetic treatments, works by paralyzing our muscles. That means it gets rid of frown lines by stopping the actions of the muscles that make them. In a similar fashion, it can get rid of the urge to urinate by paralyzing the detrusor muscle, one of the bladder muscles which makes the bladder empty on its own.
An overactive bladder is one where the bladder muscles suddenly contract, usually without warning and for no apparent reason, causing a rush of urine. The use of Botox makes people who suffer from this type of urinary incontinence still feel the need to use the toilet, but the bladder muscles become desensitized to such an extent that they don't need to go so often.
Most patients who get injections of Botox into their bladder say the effect lasted for at least six months, after which they received an additional injection and continues to see - and feel - the results. Those who were given an injection every six months for two years said they no longer felt that urinary incontinence was having any effect on their lives whatsoever.
Conclusive Proof
The most well-known study on the effects of Botox on the bladder was a Swiss one conducted in 2004. Botox is "effective" in treating urinary incontinence, the results of the study pointed out, during a presentation at a joint meeting of the Society of Gynecologic Surgeons and American Urogynecologic Society.
The study involved 26 patients, both men and women whose average age was 66, who had not responded to conventional treatment for incontinence. That meant they were unaffected by commonly prescribed medications used to control bladder spasms and relax the bladder muscles.
The group received injections of Botox directly into the muscles of the bladder, and then followed up at specific pre-arranged time periods. All of them reported back that their bladders were able to hold much more than previously, and that they emptied their bladder on average only four times a day, as opposed to 12 times. They all said that incontinence was no longer a problem that bothered them on a daily basis.
A more recent study was carried out on people suffering from urge incontinence at London's Guy's Hospital and King's College School of Medicine and published in the BJU International journal. It tested 36 people, some of whom were injected with Botox and others who received a placebo. The result showed that those who actually got the Botox felt that their incontinence had a smaller effect on their lives than previously.
What is Urinary Incontinence?
Also known as urge incontinence, overactive bladder or spasmodic bladder, bladder incontinence is when you have a strong urge to wee - often very often - sometimes to the point when you are unable to control it. It's estimated that at least 10 percent of the population suffer from this affliction, which becomes more common the older we get.
You might think that storing up and then having a wee is fairly straightforward, but it's actually a very complex process. First of all, a person must have the mental and physical abilities required to recognize they need a wee, and to control their urination. That's why newborns are unable to hold their urine, and why some older people are unable to as well.
Secondly, the lower urinary tract, kidneys and nervous system must all be in top working order for us to wee normally. We must have a normal sphincter muscle, which controls the urine flow, as well as a working bladder wall.
When we urinate, we wee in two stages. The first involves storing the urine in the bladder; the second involves pushing it out, hopefully into the proper receptacle (ie, not your pants). When a specific amount of urine is collected in the bladder, it contracts. As toddlers become potty-trained, they learn to reign in that contraction and hold it until a toilet is in sight. But for people with urinary incontinence, holding the urine is often an impossibility.
There are several types of urinary incontinence, including:
Stress incontinence. Women who have had children or are going/have gone through the menopause can suffer from stress incontinence, when they cannot control their stream of urinate due to stress being placed on the bladder. This can happen when they sneeze robustly, laugh too heartily, run or cough. One solution is to never laugh, run, cough or sneeze again. Another is to do kegel exercises, which strengthen the pelvic floor muscles. Men also get this affliction, which in their case is connected to a prostatectomy, or surgical removal of the prostate.
Urge incontinence. This happens when people suddenly leak urine as soon as they feel the urge to wee. The reasons are numerous, and can include infection of the bladder or overactivity of the nerves in the bladder.
Overflow incontinence. A consistent dribbling of urine that cannot be controlled characterizes this type of incontinence, which is usually caused by a blocked urethra or weak bladder muscles.
Suffering from urinary incontinence is no laughing matter. Many people can have their condition reversed through either intensive drug therapy, regular pelvic floor muscle exercises, or, in some cases, either invasive surgery or losing a massive amount of weight. But if these methods have all failed, Botox may be a new and exciting solution.
If you think that, like Carol Ronse, you could benefit from Botox injections to treat urinary incontinence, speak to your doctor. Don't just visit a med spa and ask someone who is used to injecting Botox into frown lines to take a detour to your bladder. You will need a competent surgeon who is familiar with the procedure to carry it out, one who has done it countless times before with a spotless track record. Good luck!
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