“An overactive bladder is over-responsive and oversensitive, so it spasms,” says Dr. Kavaler. “When Botox is injected into the muscle of the bladder, it relaxes it so it’s less overactive, less spastic. You can hold more, the urgency becomes less urgent, but you’re still able to empty your bladder.” The results, she says, can last up to six months.
I tried three of the OAB medications first. None made a noticeable difference and one gave me such sudden dry mouth, I broke into coughing fits in the middle of the street. It was time, we decided, to move on to Botox.
To get an idea how successful it might be, I spoke with Kerry Durkin, a patient of Nissrine Nakib, MD, associate professor and director of pelvic floor medicine at the University of Minnesota. Durkin lives in St. Paul and has been getting bladder Botox for over ten years, right around the time it was approved by the FDA to treat overactive bladder in 2013. Prior to that, doctors had been using it in an off-label capacity. Durkin receives it to treat frequency issues related to her multiple sclerosis (MS). According to the National MS Society, bladder dysfunction affects up to 80 percent of patients because of blockage or delays to the nerve signals that control the bladder.
“It’s changed my life,” says Durkin. “I used to get up several times during the night, maybe eight times over seven or eight hours. What kind of sleep do you end up getting? None at all. The night after I had Botox for the first time, I slept through the night.”
How does bladder Botox differ from cosmetic Botox?
Both bladder Botox and cosmetic Botox employ the same medication by Allergan. When injected into the face, results typically last about three to four months. Bladder Botox, however, can last up to six months because — even in cases of OAB — the bladder muscle doesn’t move as rapidly. “The muscles in our face are always in action and used more frequently [as we] express and move around,” says Dr. Nakib, who is a member of the scientific advisory board for medical device company Flyte. “That’s why Botox tends to fade faster there. In the case of overactive bladder treatment, the muscles aren’t moving as constantly so the effects of the Botox can last longer.”