Categories
Bladder Health

Botox & Overactive Bladders

Onabotulinum Type-A, A.K.A botox, is not only for turning back the hands of time and erasing those pesky fine lines…

Cartoon Illustration of a bladder that has had botox

Botox is a saving grace for people suffering from conditions such as chronic migraines, neck spasms, excessive sweating, lazy eye and certain conditions relating to incontinence.

The following urinary conditions can be treated with botox therapy:

In a nutshell, an overactive bladder causes someone to experience the sudden and frequent urge to urinate that often cannot be controlled. 

This can lead to the leakage of urine or the complete loss of control over ones bladder.

Urgency incontinence is characterised by the sudden and intense urge to urinate, followed by the involuntary loss of urine.

This refers to the abnormal function of the lower urinary tract. This includes the bladder, bladder neck, and/or its sphincters.

The following article will focus on how botox therapy can help those suffering from an overactive bladder (OAB). 

The cause of an overactive bladder is essentially a malfunction of the detrusor muscle found in the bladder wall. During urination, the pelvic, abdominal and bladder muscles contract. The detrusor muscle in the bladder wall contracts to help force urine from the bladder and into the urethra.

Below is a simple diagram of the bladder; the detrusor muscle is highlighted in blue.

Diagram of bladder and detrusor muscle
Simple diagram of a bladder, highlighting the detrusor muscle in blue.

An overactive bladder is characterised by dysfunctional detrusor muscle activity. The detrusor muscle contacts when it is not supposed to; meaning that one will experience an overwhelming urgency to urinate when the bladder isn’t full. 

  • Weak pelvic muscles
  • Nerve damage
  • Medications
  • Alcohol/caffeine
  • Infection
  • Excess weight
  • Oestrogen deficiency after menopause
  • Trauma
  • Radiation therapy
  • Parkinson's disease
  • Multiple sclerosis
  • Stroke
Diagram of two bladders, one normal and one overactive
A simple diagram to illustrate the difference between a normal functioning bladder and an overactive bladder.

Botox helps to regulate dysfunctional and inappropriate contractions of the detrusor muscle. Botox helps the muscles to relax and therefor alleviates sudden and sometimes uncontrollable urges to urinate.

How is the procedure performed?

Depending on which medical centre/clinic/hospital you attend, a botox installation can take place under local or general anaesthetic. 

If done under local anaesthetic while the patient is awake, the bladder is numbed before the procedure and injections begin. 

Once the patient is numbed/asleep, an instrument called a cystoscope is passed up into the bladder via the urethra. This is a thin flexible tube with a very small camera on the end that allows the doctor to visualise the inside of organs (such as the bladder in this case). A very fine needle and botox delivery system will be attached to the scope as well. With the help of the visual feedback from the cystoscope, the doctor is able to administer a series of botox injections to the bladder wall.

Simple diagram showing the inside of a bladder with a scope
Simple illustration showing the inside of a bladder with a cystoscope

The actual injecting takes only a couple of minutes. The procedure is virtually painless; however patients that have had this procedure done under local anaesthetic describe the sensation as being similar to a period cramp.

Conservative Treatment Methods & Alternatives

Prior to resorting to operative measures, some doctors may feel that conservative avenues should be pursued first. 

Conservative treatment methods are not permanent solutions to the problem of OAB. They would merely be a way to avoid having to undergo a medical procedure.

The following options may be suggested to you by your treating doctor:

Infographic showing the conservative treatment methods for OAB
Infographic showing a list of conservative treatments for OAB