Botox Injections Not Just for Wrinkles – Drug Now Approved to Treat Urinary Incontinence

Botox, the widely used wrinkle-removing injection, actually has a variety of medical uses: it’s government-approved to treat chronic migraines, muscle problems, underarm sweating and a number of other conditions. Now add to that, urinary incontinence.

In 2011, the U.S. Food and Drug Administration (FDA) approved Botox, or botulinum toxin, to treat incontinence in patients with neurological conditions like spinal cord injury and multiple sclerosis. Nerve damage from these and other conditions increase the risk for urinary incontinence. Patients often need medications to relax the bladder, as well as catheters to empty the bladder.  Current studies are evaluating the use of Botox for patients with urinary incontinence that is not due to a neurologic condition.

How does Botox treat urinary incontinence? Botox helps urinary incontinence by relaxing the bladder, thus allowing it to store more urine. In some patients with neurological conditions, over activity in the bladder leads to an inability to store urine. By injecting Botox directly into the bladder to relax it, patients gain more muscle control and less incontinence.

Botox treatment involves injection of the drug into the bladder during cystoscopy. Cystoscopy is a medical procedure that lets a doctor see inside the bladder. It sometimes requires general anesthesia.

The FDA looked at two clinical trials involving 691 patients with incontinence due to spinal cord injury or multiple sclerosis. Those who received Botox had a significant reduction in weekly incontinence episodes, compared to a placebo group. The most common adverse effects were urinary tract infection and urinary retention.

Given that incontinence is difficult to manage — typically involving drugs to relax the bladder and the use of a catheter to empty it — Botox may give some patients another option. Based on clinical trials, one injection may help control incontinence for up to 10 months.