HEALTH ADVISOR: Botox gets a makeover

BOTOX, best known for smoothing out wrinkles and affixing permanent smiles on celebrities, is also making a name for itself in treating more serious health issues for women such as overactive bladders (OAB).

An overactive bladder contracts involuntarily too often, sometimes without warning, and leads to the frustration of always feeling like you need to pee, or the embarrassment of wetting your pants.

Dr Angamuthu Arun from the Waikiki Specialist Centre says there are a number of treatments that work by calming the nerves and muscles around the bladder.

“These medicines are available in different forms, including tablets, patches, or liquids,” Dr Arun says.

But the treatments aren’t always beneficial.

“Some women may have tried more than two medications and cannot tolerate the side effects of the medications,” Dr Arun says.

“These side effects may be dry mouth, constipation and lack of concentration and feeling drowsy.

“For these women, Botox injections to the bladder may be offered as a treatment.”

Botox was recently approved as a treatment for OAB (including going on the PBS so it’s not so pricey) that’s delivered via injection.

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Dr Angamuthu Arun

Blocking

It works by blocking the muscles and nerves that lead to a feeling of urgently needing to urinate. This involves passing a small telescope (cystoscope) into the bladder through the urethra (the tube that carries your wee from the bladder to outside the body) and injecting between 10 and 20 injections of Botox into the bladder wall.

“Botox is highly effective in relieving the frequency and urgency of needing to go to the toilet and reduces urinary incontinence in majority of women undergoing the injection,” says Dr Arun.

“For the majority of women, the beneficial effects are usually seen three to four days after the injection. The Botox injection is expected to last for six to twelve months, but this will vary for each woman.

“For some women, a single treatment is all that is required: others will need repeated injections.”
There can be minor side effects, such as urinary retention which means the treatment’s worked too well and the patient finds it hard to urinate on their own, but that can usually be sorted out easily and only a few instances will they need to self-catheterise, which means passing a tube into the bladder a couple of times a day to empty.

There can also be a little blood in the urine, but that usually sorts itself out quickly with no treatment needed, and there is a risk on increased urinary tract infactions, which can be treated with antibiotics.

Dr Arun says the treatment is so simple these days that patients can return to work the next day and don’t usually need to be seen until a check-up a couple of weeks afterwards.

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