Run to the Toilet Often?
Botox is an Effective Treatment Option for Frequent Urination in Patients with Overactive Bladder and Neurogenic Bladder
Dr. Alex Shteynshlyuger is a board-certified urologist in NYC who specializes in treating men and women with urinary problems including frequent urination, difficulty emptying the bladder, urinary urgency and incontinence.
How Effective is Botox for Treatment of Urinary Frequency?
High-quality studies involving thousands of patients have shown that Botox is effective for treatment of symptoms of overactive bladder including frequent urination in men and women. The benefit of Botox persists for more than 3 years with continued treatment.
The effectiveness of Botox injections in the urinary bladder for treatment of urinary frequency does not diminish with time. Botox is effective in reducing frequent urination during the day and at night.
On average, the number of runs to the toilet is decreased by 25% from 11.7 to 9 episodes per day. There is a close to 50% decrease in the number of urinary urgency episodes from 8 episodes per day to about 4 episodes per day. In terms of urinary incontinence, on average patients experienced >60 decreases in the number of urinary leakage accidents.
HRQ0L (Health-related quality of life) is a measure of impact health problems have on the quality of life – and this was also improved in the Botox studies. The studies were of the highest quality – double-blind, so no one giving the treatment knew who was taking the drug and who had a placebo.
For example: In one study, women with OAB were divided into two groups – one group was given Botox and the other group a placebo. After six months the two groups were compared for a 24 hour period. They found that the Botox group went to the toilet fewer times, had fewer leakages and also wanted to pee fewer. In addition, a third of the women in the Botox group became continent.
The rate of urinary infection decreases over time 2%-15%. About 20% of patients develop UTI (some of these are not symptomatic).
Only 4% require catheterization after the first injection and fewer than 2% after subsequent treatment with Botox 100 u for OAB.
In another study at 20 weeks, 80% of previously incontinent women became dry and daytime frequency decreased from 11.7 to 6.2.
Importantly, Botox was safe and well tolerated in all studies. Side effects were generally easily managed and the benefits outweighed patient concern with side effects. Very few patients stopped Botox treatment because of side effects.