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Botox Effective In Incontinence Treatment

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Botox is not just useful for cosmetic surgery – doctors from Duke University have found that it works just as well as surgically implanted devices in treating women with severe incontinence.

Dr. Cindy Amundsen, the lead researcher, calls their findings good news for women, who now have treatment options available to them. She says,

What we have learned from the study is the treatments are both good, and it will just help inform physicians and patients who are trying to make a decision between these two therapies.

Amundsen adds that the researchers were not surprised at the results, because “both therapies are effective at relaxing the overactive bladder muscles,” NBC News reports.

Patients suffering from severe incontinence can now choose between a surgical procedure, which is initially more expensive, or regular Botox injections, which are cheaper and less invasive but could add up in costs over time.
The researchers examined women who had severe incontinence and could not be treated with regular medications. The women had suffered at least six occurrences of incontinence over a three-day period.

Botox injections treated incontinence in 20% of the participants, compared to 4% who were treated with a nerve stimulator implant. Overall, 46% in the Botox group and 26% in the implant group had at least a 75% rate of reduction in incontinence episodes, the researchers added.

The condition is no joke. According to the National Institutes of Health, 25% to 45% of all women have experienced some measure of urinary incontinence. The researchers wrote that the disorder is quite common, and increases with age, from 17% for females older than 45 years to 27% for women older than 75 years in the United States.

The National Institute of Diabetes and Digestive and Kidney Diseases reports that women are affected by incontinence two times more than men. This is due primarily to pregnancy, childbirth, menopause and how the urinary tract is structured. It’s an embarrassing, troubling condition that limits travel and other physical activities.
Researchers at nine medical centers compared a single Botox injection with an implanted device, randomly assigning 381 women to get either. The women were asked to document their experiences for six months.

The results showed that both treatments eased nerve signals responsible for telling the bladder to empty, and both treatments cut the number of occurrences – Botox by close to four times a day and the nerve stimulator by around three times a day.

While both groups reported equal satisfaction, more women in the Botox group contracted urinary tract infections, 35% compared to 11% in the implant group. Amundsen and her team are trying to determine the reason behind this.
The Duke team is also looking into cost differences. Most women have insurance that pays for their treatments.

There are various kinds of incontinence. This study focused on urge incontinence. There’s also stress incontinence, which is caused by pressure on the bladder, and overflow continence when the bladder remains partially emptied, which happens in men with large prostates.

Most treatment regimens for incontinence are lifestyle changes, such as less caffeine and alcohol consumption or avoiding heavy lifting. Exercises and bladder training are included, as well as medications, although the latter may cause side effects.

The study was published in the Journal of the American Medical Association.

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