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Botox: More than just cosmetic

We all know that Botox has been used primarily for cosmetic purposes, but now the Food and Drug Administration (FDA) has approved the use of Botox for treating urinary incontinence in certain medical conditions. Anne Wiskind, M.D., a urogynecologist at Piedmont, describes her specialty of urogynecology as a blend between gynecology and urology.

According to Dr. Wiskind, urinary incontinence is very common and affects about 20 million people in the United States alone. She adds that this condition amounts to billions of dollars in healthcare costs each year. Women experience urinary incontinence more commonly than men.

In fact, “most of incontinence tends to come from childbirth injury,” says Dr. Wiskind. “There are two main types of incontinence: stress incontinence, which is the bladder leakage caused by coughing, laughing and sneezing. This is caused by loss of support in the bladder neck, which usually occurs from childbirth injury,” she explains. “The second type of incontinence is urge incontinence. This is when there is leaking when you have the urge to go and cannot get to the bathroom fast enough.”

Now the FDA has approved Botox for treating urinary incontinence. “There are a couple of studies that came out recently and about 700 patients showed significant decline in overactive bladder symptoms and decreased urinary leakage in a specific population of patients with multiple sclerosis (MS) or spinal cord injuries,” she says. “This is a special population because their type of overactive bladder is very hard to control medically, because it has a distinct neurological cause.”

Dr. Wiskind believes that treating urinary incontinence with Botox is a good option for people with these conditions. “Botox has been used off-label in Europe and the United States for years – both for patients with spinal cord injuries and MS, as well as people who have an overactive bladder, not a neurological injury,” she says.

If the FDA approves Botox for the use of the more common forms of urinary incontinence, she believes it will become a more widespread treatment. “We will get better at knowing where to put the Botox and the dosing,” she says. “The trick in all cases of incontinence is to correct the problem enough so patients don’t experience leakage, but not to overcorrect the problem so patients can’t void.” As doctors continue to treat this condition with Botox, they will reach that desirable balance, she says.

In addition to reducing facial wrinkles, Botox is approved to treat severe underarm sweating, chronic migraines, eye muscles problems and spasms, and muscle stiffness. If you are experiencing trouble with urinary incontinence, speak with your doctor about the best treatment for you.

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