Harvard Women's Health Watch

Botox can help with overactive bladder

The same medicine used to smooth wrinkles might also help relieve one type of incontinence, according to a study published online January 5 in the journal European Urology. Overactive bladder (OAB)—which is caused by involuntary muscle contractions that lead to the urgent need to urinate—is twice as common in women as it is in men, especially as women age. OAB is typically treated with lifestyle interventions such as bladder retraining and medicines that relax the bladder. However, these medicines, called anticholinergics, can have side effects such as dry mouth, constipation, and blurred vision. Botulinum toxin has been emerging as a potential new therapy, although up to now there hasn't been much research to prove its effectiveness for overactive bladder. Researchers in England studied botulinum toxin A in 240 women with overactive bladder who hadn't responded to drug treatments. A total of 122 women were randomly assigned to receive botulinum toxin injections into the bladder, while 118 women received a placebo treatment. After six weeks, about 40 percent of the treated women had regained continence, and a third were still continent six months after treatment. After six months the drug's effects started to wear off. Botulinum toxin did have side effects, which included urinary tract infections (in 31 percent of the treated women) and trouble fully emptying the bladder (in 16 percent of the treated women). This was the largest study to date on botulinum toxin for treating overactive bladder, and it suggests this treatment may be an option for women who haven't found relief from other therapies.

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