Botox could soon be widely prescribed as a standard treatment for patients with an overactive bladder.
In a major study funded by Wellbeing of Women, researchers injected Botox directly into the wall of the organ and found that a single treatment reduced the symptoms of urinary incontinence by half in the majority of patients.
Overactive Bladder Syndrome (OAB) affects one in five women over 40 and can cause urinary incontinence.
It uusually occurs when the bladder muscles are too reactive, contracting even when the bladder is only marginally or half-full.
Symptoms include having to rush to the toilet at short notice, having to pass water often and nocturia (interrupted sleep patterns caused by a need to go to the toilet at night.
The researchers, led by Dr Tincello, an Honorary Consultant Gynaecologist at University Hospitals of Leicester NHS Trust, studied 240 female patients suffering from moderate to severe urinary incontinence.
The Botox treatment was given to 122 of the patients while the remaining 118 received a placebo injection of salt water.
Those treated with Botox reported a 25% reduction in the frequency of emptying their bladders and noticed far fewer instances of having to rush to the toilet at a moment’s notice.
They also reported a 50% reduction in ‘urgency’ and urinary incontinence episodes.
Almost half (around four in 10) became completely continent again after six weeks and a third were still continent six months after the treatment.
Dr Tincello said: “It’s a very positive result. Overactive bladder syndrome is a relatively common health issue which affects up to a fifth of women aged 40 and over.
“The study hopefully means much better treatment for this condition which can severely impact on quality of life and cause women considerable embarrassment.”
“Some of those affected find it hard to cope," he added. "One patient told me of a harrowing situation whereby she ended up passing water over a supermarket floor.”
However, Dr Tincello pointed out that the treatment was not without its complications.
“About one in eight women we treated had difficulty emptying their bladder at some time in the six months after treatment (due to paralysis of the bladder muscle).
“However, this was treated by teaching the women to use disposable catheters - an option they said they’d choose rather than battling urinary incontinence. The effects of the Botulinum toxin begin to wear off after about six months or so.”
Until now overactive bladder syndrome has been treated with tablets and ‘bladder training’, which involves daily pelvic floor exercises. But the tablets, which block the nerve signals to the bladder muscle and reduce the sensation of the bladder filling, can cause side effects such as a dry mouth and constipation.
“I’m delighted to say that a Botulinum toxin has much better results than a six-month course of tablets or bladder training,” said Dr Tincello.
“Our work may lead to Botox being licensed to treat overactive bladder syndrome in the UK. It may also turn out be cheaper than using a customary six-month course of anticholinergics.”
Liz Campbell, Director of Wellbeing of Women says of the study: “This is a horrible condition and often means otherwise healthy active women curtail their lives, becoming prisoners in their homes.
“It is rarely discussed but affects many women. I am delighted that Wellbeing of Women has been able to support such an important study that will improve the quality of life of many women.”
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