May 2004

University of Pittsburgh Medical Center

Univ. of Pittsburgh researcher presents six-year results of botox injections for bladder dysfunction

SAN FRANCISCO, May 9 – Botulinum toxin A injections, commonly known as botox injections, continue to show promise as a treatment for a variety of lower urinary tract dysfunctions, according to a study presented by a University of Pittsburgh researcher at the annual meeting of the American Urological Association (AUA) in San Francisco. Results will be published in abstract 517 in the AUA proceedings.

"Bladder dysfunction affects a staggering number of people worldwide," said Michael Chancellor, M.D., professor of urology and gynecology at the University of Pittsburgh School of Medicine. "Our continued success with this treatment over the past six years confirms that this is a safe and effective solution for patients experiencing many types of bladder dysfunction."

Since 1998, Dr. Chancellor has treated 110 patients, the most in North America, with botox for a variety of bladder dysfunctions, including neurogenic detrusor hyperflexia and/or detrusor sphincter dyssnerigia, overactive bladder, benign prostatic hyperplasia (enlarged prostate), bladder neck obstruction and interstitial cystitis. Each experienced involuntary contractions of the bladder or sphincter muscle spasticity, which caused incontinence typified by either uncontrolled voiding of urine or the inability to completely empty the bladder.

Of the patients treated, 74 or 67.2 percent, reported a decrease or absence of incontinence after the injections. The decrease was seen within seven days of the injection and symptoms were alleviated for approximately six months. Patients who received additional injections experienced an improvement in symptoms for a longer period of time, some for over one year. Many patients also reported an improved quality of life. None of the patients experienced long-term complications from the treatment such as stress incontinence or urinary retention.

Botox acts by binding to the nerve endings of muscles, blocking the release of the chemical that causes the muscles to contract. When injected into specific muscles, the muscle becomes paralyzed or weakened, but leaves surrounding muscles unaffected, allowing for normal muscle function.

Common urologic conditions like neurogenic detrusor hyperreflexia and overactive bladder are caused by involuntary contractions of the detrusor muscle, which controls the bladder. This new therapy helps alleviate the contractions, restoring normal bladder function.

Over 17 million Americans suffer from overactive bladder, a condition that significantly affects the patient's quality of life. An estimated 80 percent of these patients do not seek help or treatment for this condition. Overactive bladder is characterized by the following conditions: frequency, urinating more than eight times in a 24 hour period; urgency, the immediate and strong urge to urinate; and urge incontinence, the inability to suppress urgency resulting in the leaking or loss of urine.



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