BOTOX FOR YOUR BLADDER
More than 20 million people in the Untied States suffer from an overactive bladder condition. It can result from a neurological cause or can be a result of conditions like interstitial cystitis. The condition can be debilitating, and many people end up giving up all of their activities to stay home. Now, they have a new option that is giving them their lives back.
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Just leaving her home is a big accomplishment for Cindy Sinclair.
Cindy Sinclair
Has interstitial cystitis
"A year ago I was, like, hopeless. I felt hopeless and helpless."
Cindy Sinclair
"Outside of going to work, I never went anywhere."
Cindy has interstitial cystitis -- a condition that caused constant pain and the need to go to the bathroom every half hour. It was destroying her life.
Cindy Sinclair
"I nearly had a nervous breakdown about three years ago, and after going to a psychiatrist and to a therapist, the only thing that they could keep coming back to was that I was just sick, physically sick."
Today, Cindy has her life back -- with the help of botox. Urologist Christopher Smith has used botox on about 30 patients with overactive bladders. He's excited about the results.
Christopher Smith, M.D.
Urologist
Baylor College of Medicine
Houston, TX
"Patients will often go throughout the night without having to get up to urinate or get up once or twice as opposed to eight or nine times."
A tiny scope and needle are inserted into the bladder. Multiple injections are given to paralyze the nerve and keep the muscle from being stimulated.
Christopher Smith, M.D.
"Patients will go home the same day, and typically the effects will be seen within five to seven days after treatment."
After about six months, the procedure often has to be repeated. For Cindy, that's a minor inconvenience to have her life back.
Cindy Sinclair
"To go on vacation and actually get to go on the activities with your family is just remarkable."
And even being able to go to the supermarket is a chore she's happy to do.
Cindy's insurance company paid for her procedure, but Doctor Smith says because botox is not currently FDA approved for this use, many companies will not pay for it. He adds that, so far, there have been no negative side effects from the procedure.
BACKGROUND: Overactive bladder is a common type of bladder control problem and is never a normal part of aging. Symptoms of overactive bladder include: urinary frequency, urgency, or urge incontinence. In some cases the cause is neurological and in others it may be associated with interstitial cystitis. Overactive bladder dramatically affects quality of life. Though it is readily diagnosed, treatable, and often curable, most people do not discuss the symptoms of overactive bladder with their physicians. Experts estimate more than 20 million people in the United States have overactive bladder. It can cause tremendous social problems, and patients are often unable to leave their homes because of the condition. Many have to go to the bathroom as much as every half hour. Frequent urination is defined as over 10 times within 24 hours and some will go as many as 40 times a day. They often are up eight or nine times a night to urinate, which leaves them fatigued the next day. Patients are often embarrassed by the condition and do not talk about it. Medications are available to treat the condition and behavioral therapy may help as well, but while the medications may be effective they can have side effects such as dry mouth and constipation, which keep patients from using them long term.
ANOTHER OPTION: Botox is a toxin that works on muscles. It has been used for everything from getting rid of wrinkles to treating the spasticity caused by a stroke to treating migraine headaches. Now, doctors are using it to help patients with overactive bladders. The toxin paralyzes the nerves that release chemicals that cause the muscle to become stimulated. Without the stimulation, the muscle weakens and reduces the spasticity that patients have. The toxin has been used for more than 20 years and with no significant side effects. The treatment has to be repeated every three to six months, but many patients say they like the fact that it is reversible.
The toxin is delivered through a cytoscope, a small telescope, that is inserted through the urethra and into the bladder. This means no incisions have to be made in the skin. Multiple injections are made in the bladder wall so that the toxin can be spread throughout the muscle. The procedure is done either under general anesthesia or local anesthesia in a doctor's office. They can go home the same day and effects are typically seen within five to seven days after treatment.
SUCCESS: Christopher Smith, M.D., of Baylor College of Medicine in Houston, has treated approximately 30 patients with overactive bladders with Botox. He says the treatment has been successful. Patients report having to only get up once or twice during the night to urinate, as opposed to eight or nine times before treatment. They say it reduces their fatigue and improves their quality of life. Dr. Smith predicts it could even reduce the number of hip fractures in older patients suffered by falls that can happen going to the bathroom many times during the night.
John Tyler, Senior Communication Specialist
Baylor College of Medicine
(713) 798-4712
jtyler@bcm.tmc.edu
Copyright © 2003 Ivanhoe Broadcast News, Inc.
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