Can Botox Help Your Bladder Weakness?

By Barbara C. Bourassa

Chances are you're familiar with Botox, which is currently being used to treat certain types of facial wrinkles. But doctors are also studying Botox for its possibility for treating several other ailments, including bladder weakness and leakage. Although the Food & Drug Administration (FDA) to date has not approved Botox for this use, urologists say the results look very promising.

Botox is effective for treating facial wrinkles because it "freezes" the muscles around the eyes or between the eyebrows. Along the same lines, some urologists are using Botox injections to relax and/or temporarily paralyze the muscles around the bladder or sphincter.

The Botox injection uses a tiny amount of a purified substance obtained from bacteria to block the muscle's impulse to spasm or contract. In bladder weakness treatments, this creates a small degree of paralysis, which then relaxes and "dampens down the bladder's urge to misbehave," says Jamie Wright, director of urology at the Johns Hopkins Bayview Medical Center in Baltimore.

"Botox [for bladder weakness] is exciting and promising. There's lots of enthusiasm around it, and some people are calling it the next best answer," says Wright. "But it still remains to be seen whether it's effective over the long term."

Because this is such a new treatment, there's little to no research data showing whether Botox will help bladder weakness patients four to five years from now, he notes. And official FDA approval—which has been granted for treatments such as eye muscle spasms, severe underarm sweating, and frown lines between the eyebrows—is at least two to three years off.

There are several known pros and cons to this type of treatment, Wright and others note, and others may emerge over time.

First, as with Botox injections for wrinkle relief, the treatments for bladder weakness have to be repeated. This outpatient procedure only takes an estimated 15 minutes but must be repeated every six months.

Second, because the FDA has not approved this use of Botox, most insurance plans will not cover it. Treatments usually start around $300.

In addition, women may want to think carefully about pursuing a treatment that is exciting but very experimental, Wright notes. "It could be a blip, or it could become the new standard for treating bladder weakness. It's too early to tell," he says.

The treatments for facial problems are generally well tolerated, and Botox has been used since the early 1980s to treat lazy eye, according to the American Academy of Dermatology. But possible side effects for use in wrinkle relief include droopy eyelids, flu-like symptoms, headache, stomachache, or risk of botulism, according to information from the FDA.

In addition, Botox has not been approved for use on people under age 18 or over age 65. Experts advise all women to consult a doctor or health practitioner in order to assess their own medical needs, health history, and medications before pursuing treatment, and only to receive Botox treatments in a professional clinic or doctor's office.