FDA approves Botox injections for overactive bladder

When you think of Botox injections, you probably think of getting rid of unwanted wrinkles around the eyes or forehead, but recently the US Food and Drug Administration (FDA) approved using the injections to help patients with neurological conditions who suffer from incontinence, or an overactive bladder.

Botox injections paralyze the bladder muscle to prevent contractions that cause urgency to urinate or leak. Although medications and behavioral modifications are treatment options, many patients, especially the elderly, do not respond to these methods and need a more aggressive approach.

"About 80 percent of patients with neurological conditions, such as spinal cord injuries, Parkinson's disease and multiple sclerosis, see improvement after about a week, and the results can last four to nine months," said Charles Nager, MD, co-director of the UC San Diego Women's Pelvic Medicine Center at UC San Diego Health System.

Incontinence is the seventh condition, including chronic migraines and underarm sweating, that Botox has been approved to treat since the drug first arrived on the market as a wrinkle reducer in 2002.

The outpatient procedure uses a local numbing gel, followed by 15 to 20 injections in different areas of the bladder muscle.

"It can really be life changing for someone with severe incontinence issues," said Nager who also serves as director of Urogynecology and Reconstructive Pelvic Surgery in the Department of Reproductive Medicine at UC San Diego.

UC San Diego Health System is currently recruiting for a clinical trial to test Botox injections versus sacral nerve stimulation as incontinence treatment options.

Sacral nerve stimulation uses small, electrical impulses to the nerves that control urination. The impulses are generated by a small device surgically placed under the skin. Attached to the device is a thin, electrode-tipped wire that passes under the patient's skin, carrying impulses to the sacral nerve. The surgery is an outpatient procedure done under local anesthesia.

Patients involved in the clinical trial are required to have tried two drugs that previously failed to treat their incontinence issues.