December 31, 2003
New York Times Syndicate
Botox, the injectable toxin that temporarily paralyzes muscles and is hot for cosmetic uses with people who want to freeze away frowns, is gaining ground for more purely medical purposes.
Originally intended as a noncosmetic drug, Botox is being used increasingly for purposes such as treating bladder and urinary sphincter disorders, headaches, eyelid twitching, carpal tunnel syndrome, and excessive sweating, among others.
Dr. Steven Varady of University Urologists in Lake Worth, Fla., is using it with his patients who have overactive bladders.
He's tried it on about a half-dozen so far. It takes about a week to reach maximum effectiveness, but it reduces urgency and incontinence with minimal or no side effects.
``Several patients have benefitted dramatically,'' he said.
Botox is injected in small doses into the bladder wall in five to 30 locations for management of overactive bladders. For help with urinary sphincter muscle problems, it's injected into that muscle.
Botox produces a temporary paralysis of the injected muscles, improving and sometimes resolving symptoms completely, Varady said.
Patients with multiple sclerosis, spinal cord injury, and stroke can also benefit when spasming or spasticity of muscles produces incontinence.
A study done by the University of Pittsburgh, and presented last year at the American Urological Association, showed that patients experienced the results Varady's patients have achieved.
Forty-one of the 50 patients reported a decrease or absence of incontinence after the injections. The decrease was seen within seven days of the injection and symptoms were alleviated for approximately six months. None of the patients experienced long-term complications to the treatment such as stress incontinence or urinary retention.
More than 17 million Americans suffer from overactive bladder, a condition that significantly affects the patient's quality of life. An estimated 80 percent of these patients do not seek help or treatment for this condition, according to the American Urological Association.
Overactive bladder is characterized by frequency, urinating more than eight times in a 24-hour period; urgency, the immediate and strong urge to urinate; and urge incontinence, the inability to suppress urgency resulting in the leaking or loss of urine.
While excited about the results, Varady doesn't think Botox will become a first-line treatment for overactive bladders, except, perhaps, ``in a population who is truly miserable.''
It costs about $1,000 for a treatment that, while lasting up to 10 months, is temporary. And many patients prefer taking pills to getting injections, he said, even though there can be unpleasant side effects from pills.
Still, it's good to know that people with such a distressing condition
may be able to find some peace of mind, however temporarily.
Copyright © 2003, New York Times Syndicate