Botox has long been used as a cosmetic treatment. But now, cutting-edge health professionals are also using the wrinkle eraser as a noninvasive way to help women cope with incontinence. Tanaz Ferzandi, MD, MA, Tufts Medical Center director of the Division of Urogynecology and Pelvic Reconstructive Surgery, shares how the surprising treatment works—and how it’s helping many of her overactive bladder patients live symptom-free.
How many women are affected by overactive bladder?
It’s very common. But because it’s a topic that most women don’t talk about, we don’t have much in the way of hard numbers. Many women think that incontinence is a normal consequence of aging or childbirth, but that isn’t true.
How have doctors traditionally treated overactive bladder?
First, we would start with lifestyle modifications, like better fluid management and toileting habits. For instance, drinking caffeine and alcohol can lead to more frequent bladder activity. Physical therapy, such as working to increase the amount of time between emptying the bladder, can be another treatment tool. There are also effective medications, but those can have side effects. The final option might be stimulating nerves in the leg or tailbone to influence the bladder muscles, but the procedure is invasive.
How is Botox for overactive bladder different?
In 2013, the FDA approved Botox as a treatment for overactive bladder, which added to my arsenal of options for my patients. I had a treatment that was in between lifestyle modifications and invasive surgery that could be performed in-office.
A lot of people know that Botox is used to treat wrinkles by causing temporary muscle paralysis. When the bladder muscle is overactive, it wants to contract and release urine too often, even if it isn’t full. By injecting Botox into the bladder muscle, we induce a temporary paralysis that helps quiet the feeling of having to go urgently or frequently. Botox allows the bladder to fill to a higher capacity and helps women hold their urine for longer.
How is the procedure performed?
We insert a tiny camera called a cystoscope into the urethra, the tube that empties urine into the bladder. As we look at the bladder through the camera, we use a small needle to introduce the Botox throughout the bladder wall. Since this can be uncomfortable for some patients, we offer numbing solutions or anesthesia.
Are there any side effects?
Not many. In a small number of patients, the Botox can work a little too well. That can cause the bladder to become too quiet and not empty properly. In those instances, patients need to be aware that they may need to self-catheterize for a short period of time.
Why should women consider Botox to treat their overactive bladder?
It’s an effective treatment option between lifestyle modifications and more-invasive procedures, and it can be performed in-office. There’s no recovery time, and you can go home the same day. Plus, research has shown that Botox treatments are more cost-effective than medication, and they can last up to 10 months.
It’s really about improving your quality of life. Women with an overactive bladder should talk with their physician, who can help sort out the best treatment options for them.