Botulinum toxin (commonly called BOTOX®) is often used in cosmetic procedures. BOTOX is also a relatively new treatment for severe urge incontinence that has not responded to medical therapy. It is also for the treatment of overactive bladder (OAB) with symptoms of urge urinary incontinence, urgency and frequency. It is only for use in adults who have had an inadequate response to, or are intolerant of, anticholinergic medication. In this treatment, BOTOX is injected directly into the bladder muscle, relaxing it and allowing the bladder to fill with more urine before the urge to urinate strikes.
When injected at doses approved by the FDA into a specific muscle or gland, BOTOX is expected to act locally to produce a safe and effective result. This effective result usually lasts between three to ten months, depending on the approved indication and on the individual patient.
It has been found that after botulinum toxin injections some persons are unable to pass urine at all. Therefore, all persons undergoing this treatment must be prepared to use an intermittent catheter to empty their bladder if this side effect occurs.
BOTOX (onabotulinumtoxinA) bladder injections were approved by the FDA in 2011 for urinary incontinence due to detrusor overactivity associated with a neurologic condition in adults (18 and over) who have an inadequate response to, or are intolerant of, anticholinergic medication. In January of 2013, the FDA approved of its use for the treatment of overactive bladder (OAB) with symptoms of urge urinary incontinence, urgency and frequency in adults who have had an inadequate response to or are intolerant of an anticholinergic medication.
If you are interested in this treatment, speak to your healthcare provider to learn more and to see if you are a good candidate for this treatment.
Medical Reviewer: Catherine DuBeau, MD
Dr. DuBeau, MD, is Professor of Medicine at the University of Massachusetts Medical School, Worcester, Massachusetts. She has been actively engaged in teaching, management, and research regarding urinary incontinence in older persons for over 15 years. Her research focuses on quality of life impact and patient-centered outcomes. She has published numerous articles and book chapters on urinary incontinence and benign prostate disease. She was a member of the Urinary Incontinence Technical Subgroup of the National Committee for Quality Assurance that developed the Health Plan Employer Data and Information Set (HEDIS) regarding urinary incontinence, and chaired the Evaluation Committee for developing the National Association for Continence (NAFC) Blueprint for Continence Care in Assisted Living. Dr. DuBeau has co-chaired the Frail Elderly Committee for the 2004 3rd International Consultation on Incontinence. She is a member of the Editorial Board of the Journal of the American Geriatrics Society, and in 2004 was awarded the AGS/NAFC Continence Care Champion Award. She is a dedicated teacher and lectures nationally and internationally on incontinence.