Botox treatment provides relief for bladder problems Published March 2, 2009 By Linda Frost 59th Medical Wing Public Affairs LACKLAND AIR FORCE BASE, Texas -- If your lifestyle is hampered too often by embarrassing moments when nature calls, the Wilford Hall Medical Center's Incontinence Clinic offers hope. Urinary incontinence is a common problem for many; but, for some people, it can disrupt their lives. Medical reports indicate those who suffer from severe cases of urinary incontinence are forced to avoid vacations, cancel social events and the problem even takes away from quality time with family members. More than 13 million Americans suffer from incontinence or overactive bladders (OAB). Stress incontinence, which is more common in women, is the leakage of urine that occurs with coughing, sneezing, or physical activity. Stress incontinence can occur after childbirth and can also manifest as one ages. An overactive bladder is manifested by urinary frequency and an urgent need to urinate. The most severe form of OAB is urge incontinence in which leakage occurs before making it to the bathroom. Col. (Dr.) Duane Cespedes, director of the WHMC Incontinence Clinic, says there are many ways to treat incontinence. Stress incontinence is usually treated with behavioral therapies or minor surgical procedures. Overactive bladder and urge incontinence are most commonly treated with behavioral changes and medication. For the more severe cases, injections of Botox into the bladder are an easy outpatient treatment and the patient can generally return to work or other activities the same day. Even though Botox is most commonly used for relaxing muscles in the face for cosmetic purposes, it is also now being used for relaxing the bladder. It is a newer option, used only within the past four years or so. Wilford Hall Medical Center is one of the very few Air Force hospitals in the world that offer the Botox treatment. "Botox is used only when medications do not work. It is used for those who suffer from urge incontinence, the most severe form of an overactive bladder," said Doctor Cespedes. "The urge can be so strong and happen so suddenly that there is not enough time to get to a bathroom." The treatment tends to stabilize the bladder and increase the amount of urine the bladder will hold, which results in the ability to control the urgent need to go to the bathroom. Each injection will last about a year, depending on the individual. Although Botox has been shown in studies to effectively treat urinary incontinence, it has not yet been approved by the Food and Drug Administration, therefore, insurance companies will not cover this treatment in private clinics. Implant surgery - much like a "pacemaker" for the bladder - is another option for urge incontinence, but requires hospitalization and recovery takes longer. "It's a very tough thing to live your life running from bathroom to bathroom. If you look at quality of life issues, urinary incontinence is worse than diabetes and worse than asthma," said Doctor Cespedes. For more information, individuals should speak with their primary care physician for a referral to the WHMC Urology Department. USAF. (U.S. Air Force Graphic by Rosario "Charo" Gutierrez) Photo Details / Download Hi-Res USAF. (U.S. Air Force Graphic by Rosario "Charo" Gutierrez)