Health Watch

HealthWatch: Botox for the Bladder

BALTIMORE, Md. (Ivanhoe Newswire) -- Overactive bladder is a common problem, especially as we age, but it's something that most of us probably don't want to talk about.  Now, a cosmetic procedure that is much better known for erasing facial lines is starting to gain ground among women who feel like they always "gotta go."  
For 65-year old Karan Kipp, the doctor's office used to be as far as she would venture from home. She was always racing to the restroom. 
"I have the feeling I have to go to the bathroom and by the time I was moving I was gushing," Kipp shared.
Karan tried medication. Adjusted her diet. Did Kegel exercises to strengthen weakened muscles. Nothing worked. Urogynecologist Mark Ellerkmann suggested another option. A shot of botox for the bladder.
"Botox is a potent neurotoxin and it basically is produced by a bacteria called clostridium and in small amounts can be helpful at paralyzing the muscle," Said R. Mark Ellerkmann, MD, Director of Urogynecology at the Weinberg Center for Women's Health and Medicine, Mercy Medical Center, Baltimore.
"My grandma always called your area down there your "Susie", and I thought oh my god, my "Susie's" getting Botox before my face," Kipp laughed.
The procedure is done under light sedation using a tiny tool called a cystoscope.
Dr. Ellerkmann said, "Using a small camera and a scope we fill the bladder up with water or saline, and then we take a very tiny needle and inject the Botox." 
Doctors make about 20 injections into the bladder. Kipp said she noticed the difference right away. 
"It was gone. I was in control. It wasn't like I stopped drinking water or anything like that. I was in control," Kipp told Ivanhoe.
Dr. Ellerkmann says the procedure can be repeated if needed, but patients need to wait at least three months in between injections. Botox is FDA approved for treating overactive bladder, and is covered by most insurance companies.
Contributors to this news report include: Cyndy McGrath, Field and Supervising Producer; Hayley Hudson, Assistant Producer; Roque Correa, Videographer, Roque Correa; Editor.
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REPORT:    MB #4401

BACKGROUND: Overactive bladder causes a sudden urge to urinate. The urge may be difficult to stop, and overactive bladder may lead to the involuntary loss of urine, also known as urge incontinence. Overactive bladder occurs because the muscles of the bladder start to contract involuntarily even when the volume of urine in your bladder is low. Director of Urogynecology at Mercy Medical Center, Dr. Mark Ellerkmann, says that overactive bladder is more prevalent in women. Several conditions that may contribute to signs and symptoms of overactive bladder include, but are not limited to: neurological disorders such as stroke and multiple sclerosis, diabetes, diuretic medications, excess weight, and excess consumption of caffeine or alcohol. Symptoms of overactive bladder include feeling a sudden urge to urinate, experiencing a urge incontinence, urinating frequently (usually 8 or more times in 24 hours), and getting up to urinate in the middle of the night two or more times (also known as nocturia).

TREATMENT: Management of overactive bladder often begins with behavioral strategies, such as fluid schedules, timed voiding and bladder-holding techniques using your pelvic floor. Dr. Ellerkmann says that a 24 hour to 3 day voiding diary is very helpful because it can give doctors a little more specific information about what is being consumed especially with respect to bladder irritants. If these initial efforts don't help enough with your overactive bladder symptoms, doctors will often prescribe medications known as anticholinergics. If both the behavioral strategies and the medications don't provide enough relief, surgery may help. One procedure works by supporting the bladder so that it returns to its normal position. Another surgery, called a sling procedure, uses a strap of synthetic mesh or natural tissue to support the urethra.
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NEW TREATMENT: Botox is now being used as a different treatment option because it works on the bladder muscle by blocking the nerve signals that trigger overactive bladder. Because Botox is a potent neurotoxin and it is produced by a bacteria called clostridium, in small amounts it can be helpful at paralyzing the bladder muscle. This treatment option might be helpful for those who haven't responded to other medications. After using local, regional, or general anesthesia to numb the bladder, the urologist will make small injections in the bladder wall, where the bladder muscle is located. The patient can also opt for no anesthesia. The urologist can do this either in the hospital or in his or her office as an outpatient procedure. The entire process can take less than an hour, and benefits can last several months. Studies have found that Botox significantly improves symptoms of incontinence and causes few side effects. By reducing bladder contractions, Botox~can help reduce weekly urinary leakage episodes, increase~bladder capacity, and decrease~the pressure in your bladder.


Dan Collins

If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know~to seek or change treatments, please let us know by contacting Marjorie Bekaert Thomas at

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