What Are the Uses of Botulinum Toxin Type A (Botox) Injections in Urology?

In urology, botox injection is used as an effective method in the treatment of some urological problems. In overactive bladder disease, botox injection is preferred to relieve involuntary muscle spasms that cause frequent urination or incontinence problems. In cases such as prostate pain syndrome or bladder pain syndrome, muscle tension can be reduced and the severity of pain can be alleviated with botox injection.

Botox has also been used experimentally in the treatment of prostate hyperplasia (BPH), but its use is not recommended because successful results have not been achieved. Studies have been conducted on botox injection into the penis in erectile dysfunction and some studies have been found successful, but since there are not enough studies, its routine use is not yet recommended in the guidelines. These areas of use increase the benefits and treatment options of botox injection in urology.

Overactive Bladder Treatment

I. What is Botox Injection and How Does It Work?

Botox injection, when applied to the bladder muscles, causes temporary paralysis of the muscles.
This regulates urinary control by preventing excessive contraction of the bladder and involuntary contractions.
The injection process is usually performed under local anesthesia and takes approximately 15-30 minutes to complete the process.

II. Effectiveness and Duration of Botox Injection

The effectiveness of botox injection in the treatment of overactive bladder continues for 3-6 months.
During the treatment period, patients usually experience significant relief and improvement in urinary control.
However, the effect of Botox decreases over time and repeated injections may be required.

III. Potential Side Effects and Risks

Although Botox injection is a safe and effective treatment option, it also has side effects and risks.
Side effects such as mild pain at the injection site, temporary difficulty urinating, or urinary tract infection may occur.
For this reason, it is important that the specialist who will apply the botox injection treatment is experienced and the patients are followed regularly.
Botox Injection for Urinary Incontinence Problems: Treatment and Effects

I. Urinary Incontinence Problems and Botox Injection

Urinary incontinence problems are a common urological problem that affects women more frequently and can affect both young and old women. It is a condition that can be seen in men, especially with aging and after prostate surgeries, and can sometimes be seen in diseases such as overactive bladder.
Botox injection provides successful results, especially in patients who have inadequate response to treatment despite lifestyle changes and oral medications.

II. Working Principle of Botox Injection

In patients with complaints such as overactive bladder, involuntary urinary leakage, or a feeling of urgency and frequent urination, complaints can be alleviated by preventing uncontrolled contraction of the bladder muscles.
Botox injection creates temporary paralysis in the muscles and reduces the excessive contractions of the bladder muscles, thus reducing the complaints of the patients.

III. Botox Injection Process

Although the injection is usually performed under local anesthesia, it is sometimes performed under general anesthesia and small amounts are injected into different parts of the bladder with an optical system called a cystoscope.
The procedure time is generally short, averaging 10-15 minutes.

IV. Effect Duration and Side Effects of Botox Injection

• Although the effect of Botox may vary individually, it generally lasts between 3-6 months.
  Patients experience a significant decrease in their frequent urination, feeling of urgency and urinary incontinence problems.
  Temporary side effects may occur after the procedure, but they are usually mild and temporary.
  Temporary side effects may include inability to urinate, urinary tract infection, or difficulty urinating.

  V. Importance of Botox Injection and Result

  Botox injection is an important and successful treatment option for overactive bladder symptoms.
  This method offers an effective solution by reducing uncontrolled contractions of the bladder muscles.
  Interstitial Cystitis or Bladder Pain Syndrome

  I. Definition of Interstitial Cystitis or Bladder Pain Syndrome

  There are symptoms of pain in the bladder area and frequent urination, especially with bladder filling, without any proven infection or other pathology in the bladder.

  II. Interstitial Cystitis and Bladder Pain Syndrome Symptoms

  Although the patient sometimes cannot precisely localize the pain, he describes pain in the bladder area, and this pain gradually increases, especially as the bladder begins to fill. An increase in urinary frequency may occur at night and/or during the day, and urinary burning may also be felt.

  III. Botox Injection and Treatment Method

  The use of Botox injection in the treatment of interstitial cystitis or bladder pain syndrome has been used for some time and there are successful studies. It is recommended as fourth-line treatment in the American Urological Association guidelines.
  Botulinum toxin relaxes the bladder muscles and reduces pain.
  The injection procedure is performed under local anesthesia and takes about 10 minutes.

  IV. Effect and Duration of Botox Injection

  Botox injection causes a significant reduction in symptoms.
  It results in decreased urination frequency, relief of bladder pain and improved quality of life.
  Although its effect usually lasts between 3-6 months, there are also studies showing that it lasts up to nine months, and it can be repeated if symptoms recur.

  V. Evaluation and Application of Botox Injection

  It is important that the treatment decision is evaluated individually and applied to appropriate patients.
  It is important to know that it is an effective option in the treatment of interstitial cystitis or bladder pain syndrome.
  The fact that it can improve patients’ quality of life and relieve pain makes the treatment important.
  Prostate Enlargement

I. Botox Injection

Botox injection has also been tested for its effectiveness in the treatment of prostate enlargement.
Botulinum toxin is injected into the smooth muscles of the prostate to relax the muscles, thus opening the urinary tract and allowing them to urinate more easily.
However, when the results after Botox injection were compared with placebo, unfortunately the desired results were not achieved and therefore its use in benign prostate enlargements is not recommended by the guidelines.
However, there are studies showing that it gives successful results in prostate pain syndrome as well as bladder pain syndrome. Although its use is not yet clearly recommended in the guidelines due to the insufficient number of studies, it is among the options that can be applied for experimental purposes by deciding together with the patient.
Erectile Dysfunction

I. Causes of Erectile Dysfunction

Psychological factors: Psychological problems such as stress, anxiety, depression
Organic factors: Hormone irregularities, nervous system disorders, Aging, Diabetes
Relational factors: Relationship problems, lack of communication

II. Erection Treatment with Botox Injection

The use of botulinum toxin injections has also been the subject of research in erectile dysfunction.
The purpose and mechanism of action of Botox injection is to increase blood flow to the penis by relaxing the penile smooth muscles and thus providing an erection.

Regarding the current studies, although there are studies that provide successful results, especially in mild and moderate cases, the number of studies is not yet sufficient and therefore routine use is not yet recommended by the guidelines. However, it can be applied within scientific study groups by giving detailed information to patients who do not respond adequately to oral treatment and do not want penile prosthesis surgery.

Source:

https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/how-do-bladder-botox-injections-work