Use of Botox in Bladder and Prostate Diseases

By Allen A. Farsaii, MD

Germantown Urology Center

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Use of Botox in Bladder and Prostate Diseases

Recently, a seminar was held at UCLA by Dr. Shlomo Raz, a pioneer on urinary incontinence. Raz spoke about using Botox to treat overactive bladders and even the prostate. Although this is not FDA approved, it appears that using Botox in a variety of bladder disorders, including overactive bladders and spinal cord injury may be helpful.
Presently Antimuscarin, Ditropan, Detrol, and Vesicare are common treatments for an overactive bladder (OAB). These treatments are gaining popularity in the United States and Europe.
In a European study, Botox
was injected into the bladders of
participants that consisted of patients with both non-neurogenic and
neurogenic incontinence. The initial result was encouraging; between 65-70% of patients were dry at least 18 months after the procedure. All patients had good bladder pressure (proven by a cystometric), and symptoms of frequency and urgency decreased.
Another use of Botox in bladder conditions is sphincter dyssenergia, a condition in which the bladder and urinary sphincter do not cooperate with each other. This can lead to damage to the kidneys and infection.
Benign enlargement of the prostate has similar signs and symptoms to overactive bladder. The botolinum toxin has been shown to prevent growth of prostate tissues and again, studies have shown prostate symptoms and intravesical pressure decreases following the injection of Botox into the prostate. Even preliminary studies indicate prostate specific antogen (PSA) and prostate cancer may diminish in numbers with the use of Botox treatments.
We hope that in the near future Botox will be approved by the FDA for treatment of prostate and lower urinary tract disorders.
For more information speak to your urologist about these exciting new developments.