A 56-year-old British woman says she has been able to get rid of a seemingly intractable urinary incontinence thanks to Botox.
In an interview, Carol Ronse of Sussex said, "The whole procedure, carried out under local anaesthetic and as a day patient, was uncomfortable - rather like pinching but inside my tummy - yet not painful. The procedure lasted around 20 minutes and afterwards I felt no pain at all and went home.
AdvertisementJust five days later, the problem cleared up. From desperately needing the loo around 20 times a day, it went down to just seven times.
After around nine months the effects did start to wear off and I went back for a second injection. I will need to have these 'top-ups' indefinitely.
Still the change to my life is immeasurable.
Quite simply, after 20 years of problems, at last I feel normal."
From cosmetic facelift to setting right the bladder is indeed a long way.
When the bladder is full, messages from nerve endings in the organ cause the bladder muscle to contract. In patients with incontinence, this occurs up to 20 times a day. Now the trick is to block the neurotransmitters from directing the bladder to contract, as it were.
Pelvic floor exercises can help, as can drug therapy. Anticholinergic tablets are effective in 60 per cent of sufferers. But others may have to resort to surgery to tighten or support the muscles.
If all else fails, a urinary bypass and the need for self-catheterisation may be the only option. Botox seems to be changing the depressing scenario.
It was four years ago that surgeons started using Botox to block the neurotransmitters and that way prevent the bladder muscle from contracting so much, says Mohammad Shamim Khan, a consultant urologist of London, who treated the harried Carol.
Basically, Botox desensitises the action just enough to ensure you still need the loo, but you no longer need to go so often. As the Botox wears off, the treatment needs to be repeated.
There is a possibility the body could become resistant to the Botox, but nobody has encountered that yet.
"During the procedure we applied local anaesthetic gel to the urethra all in your (the narrow channel through which urine passes from the bladder out of the body) and passed a flexible telescope into the bladder, where additional local anaesthetic was placed.
A needle was then passed up through the telescope to inject Botox into ten random sites in the bladder," explains Mohammad Shamim Khan.
Carol was kept in for an hour after treatment to make sure she didn't suffer any adverse reaction, such as anaphylactic shock - a rare but dangerous allergic reaction to Botox - and to ensure she could pass urine easily. A little bit of blood in the urine is normal after such a procedure.
A week later, Carol noticed a real difference. The amount of time the effects last varies from person to person. On average it's around nine to 12 months, but it can last as long as 20 months. Either way, a simple top-up is all that's required to repeat the positive effects. And for people like Carol, it's a real life-changer," observes
Privately, the initial operation and further top-ups cost around £2,200 each time. It costs the NHS around £850 each time, reports the Daily Mail.
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