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Botox May Put the Brakes on Overactive Bladder

Injections of Botox may be as good as pills for putting the brakes on an overactive bladder.

Overactive bladder is marked by a sudden, uncontrollable urge to urinate, which can lead to the involuntary loss of urine, called urge incontinence. Botox works by relaxing the bladder muscle. It is already FDA-approved to treat urinary incontinence due to overactive bladder related to nerve damage from conditions such as multiple sclerosis and spine injury.

But doctors are allowed to use their own judgment to prescribe Botox “off-label” to treat overactive bladder from other causes.

Medications called anticholinergics are also used for overactive bladder. They work to relieve symptoms by relaxing the muscles of the bladder.

In a new study of nearly 250 women who had urge incontinence, a one-time Botox injection in the bladder worked as well as daily pills at reducing episodes of urinary incontinence at six months. Fully 70% of women in both groups reported an average of three leaks a day at the six-month mark compared to an average of five a day at the start of the study.

What’s more, twice as many women who received the Botox reported that their incontinence went away.

Still, much like with wrinkles, the effects of Botox on the bladder don’t last forever. Women will likely need another injection within nine months to a year to keep their bladder symptoms under control.

The findings are published in the Oct. 4, 2012, issue of the New England Journal of Medicine and being presented at the annual meeting of the American Urogynecologic Society in Chicago.


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