Urinary incontinence – this is a serious problem with which patients usually turn to a urologist or gynecologist, however, many even prefer to silently endure the unpleasant consequences of this condition. Often the solution to a problem seems difficult or impossible, but fortunately it is not.
Today, botulinum toxin injections are used to treat urinary incontinence due to idiopathic overactive bladder or detrusor overactivity.
About the technique of drug administration, choosing the right dose of toxin in an interview with estet-portal.comPhD, urologist of the highest category Dmitry Mikhailov.
Botulinum therapy for the treatment of urinary incontinence
Overactive bladder – is a syndrome characterized by urinary urgency (with or without urinary incontinence), and is often accompanied by nocturia and frequent urination.
Both idiopathic overactive bladder and neurogenic detrusor overactivity involve the neuromuscular apparatus of the bladder. In this regard, injections of botulinum toxin, which blocks neuromuscular transmission, allow you to solve this problem quickly and safely.
An anesthetic is injected into the bladder to correct urinary incontinence before botulinum therapy.
A diluted pain reliever may be injected into the bladder before starting treatment. However, with this type of anesthesia, the bladder must then be drained and flushed with sterile saline.
For better visualization, a sterile sodium chloride solution is injected into the bladder, but it is important to avoid overdistension of the bladder. After the procedure, this saline solution is not drained: it is necessary to wait until the patient himself can empty the bladder.
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Treatment of idiopathic overactive bladder
The recommended dose of BOTOX® by Allergan for correcting idiopathic overactive bladder is 100 units. It is administered in 5 units (0.5 ml) of the drug at 20 points of the detrusor under the control of a cystoscope, avoiding the triangle and the bottom of the bladder. Depth of introduction of a needle – 2mm, and the distance between the injection points should be applied 1 cm.
After the procedure, the patient must be monitored for a minimum of 30 minutes until spontaneous bladder emptying is observed.
Clinical improvement occurs within 2 weeks.
When the effect weakens, a second botulinum therapy is recommended, but it can be carried out no earlier than 3 months after the previous treatment.
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Treatment of urinary incontinence due to neurogenic detrusor overactivity
Neurogenic detrusor overactivity is most commonly treated with anticholinergics. In case of a poor response to treatment, sometimes several drugs of this group are prescribed at once.
Failure or poor tolerance of oral drug therapy is an indication for botulinum therapy.
Neurogenic detrusor overactivity requires more intensive treatment than idiopathic overactive bladder. The recommended dose for correcting this condition – 200 units of BOTOX® of the company "Allergan". The drug is injected 1 ml in parallel at 30 points. For this procedure, it is also necessary to have visual control with a cystoscope. The results are evaluated within the first 14-20 days. If necessary, re-correction can be carried out, however, not earlier than after 3 months.
Botulinum toxin therapy is an excellent alternative to oral drug therapy for overactive bladder, and can significantly improve the quality of life of patients with urinary incontinence.
Original drugs of the company "Allergan" You can only purchase from an authorized distributor.
Read also: What Botulinum Toxin Can Do: Unique Possibilities of Using BOTOX Drugs®
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