Those suffering with multiple sclerosis are aware of the problems that it causes with the bladder, in particular an overactive bladder.
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a service of the National Institutes of Health (NIH), an overactive bladder includes: urge incontinence; urinary urgency; urinary frequency; and nocturia. The urgency or “incontinence occurs because of problems with muscles and nerves that help to hold or release urine.” (1)
The NIDDK also notes that urge incontinence (UI) is more prevalent in older women, due to pregnancy, childbirth, and menopause, along with the female anatomy. It is also considered a medical problem and may be caused by multiple sclerosis, neurological injury, and aging, along with other factors.
If you suffer from an overactive bladder, you know of the inconvenience and problems that it can have on your life. Planning a day out or a trip? You need to know when and where there will be a restroom. If overactive bladder is severe enough, an hour’s drive or outing without a restroom may be problematic. Need to wait on line for any length of time? Be prepared. Laughing too hard or coughing, you’re in trouble. Even a sneeze may put you in an embarrassing situation.
An overactive bladder is a lifestyle changer. You no longer think of doing this and that. You think of this and that in relation to restroom access.
Two of the most popular treatments for an overactive bladder are Botox injections and oral medications, known as anticholinergic medications. In an effort to determine which treatment more effective, the National Institutes of Health (NIH) conducted a study that offers insight into the pros and cons of each.
The six month study, which is the first to compare the effectiveness of oral medication and Botox injections, targeted ‘urge urinary incontinence’ and consisted of approximately 250 women with an average age of 58 years. According to the NIDDK, urge incontinence is a “leakage or gushing of urine that follows a sudden, strong urge.” (2)
The study participants were randomly divided into two groups: one received Botox injections and placebo pills, the other received oral anticholinergic medication and saline injections. This was a double blind study, neither the participants nor the doctors administering the medications knew ‘who got what.’
Improvement was noticed by approximately ninety percent of the women within one month. At the end of the six months, approximately seventy percent of each group cited adequate control of their symptoms.
The results of the study demonstrated that both treatment groups claimed improvement. Daily episodes were reduced from around five times a day to once or twice. Along with this, twenty-seven percent of the participants who received the Botox were urinary leakage free after the six month trial period, compared to thirteen percent in the oral medication group.
The participants did note that the oral medication caused several side effects, including: dry mouth and eyes, and constipation. The Botox group experienced bladder infections and incomplete bladder emptying.
Susan F. Meikle, M.D., M.S.P.H., study senior author, stated that the results of the study indicate that Botox might be a first line treatment option.
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