Botox, which has been smoothing wrinkles
for years, now it will also help in relief
of the bothersome urinary symptoms
associated with an enlarged prostate
or bladder conditions.
Botulinum toxin (BTX), a neurotoxin
produced by the gram-positive, rod-shaped anaerobic bacterium Clostridium
botulinum, was isolated in 1897 by Belgian scientist Professor Pierre Emile
van Ermengem. BTX acts by blocking the release of acetylcholine at the neuromuscular
junction. As a result of this chemodenervation, a temporary flaccid paralysis
ensues. Different medical disciplines have taken advantage of this temporary
paralysis to treat muscular hypercontraction. BTX was first approved by the US
Food and Drug Administration in 1989 for use in patients with strabismus and
blepharospasm. Since then, BTX has been used to treat a number of different
neuromuscular disorders. BTX has been used successfully in urology to treat
neurogenic and non-neurogenic detrusor overactivity, detrusor-sphincter
dyssynergia, motor and sensory urge, and chronic pain syndromes.
The BOTOX toxin is of various types:A
to F.The BOTOX A is the more potent with greater duration of action.It has wide
urological applications.The BOTOX will bind irreversibly to presynaptic
membrane and cause skeletal muscle atrophy but the axons will regenerate after
3-6 months.
BOTOX has been used in many
urological consitions such as intractable overactive bladder,neurogenic bladder
causing upper tract damage(kidney damage),Detrusor-External Sphicter Dyssenrgia(
causing intermittent flow,obstructed stream in Neurological illnesses),chronic
prostatic pain,non fibrotic bladder outflow obstruction(prostatic enlargement).
But the most common usage of BOTOX is
in irritative bladder symptoms (frequency,nocturia,urgency,urge incontinence
not yielding to medicines).The overactive bladder symptoms if doesnot abate
with usual anti-cholinergic medications makes the life of the patient
miserable. It will have physical problems-leakage
causing personal inhygiene, psychological problems-embarrassment and loss of
dignity, social problems-social isolation, sexual problems- because of genital
skin rashes and foul smell( partner will have repulsion) etc.
The overactive bladder is widely
prevalent affecting 50-100 millions of people all around the globe and some
of them don’t respond to conventional
treatments.These are the people who suffer silently and eventually end up in
depression and self esteem.The BOTOX provides a ray of hope in such patients.
Typically 100-300 Units of BOTOX –A toxin is used. Briefly,
the BoNT/A dose (200 or 300 units) is reconstituted with saline 0.9% at a total
volume of 30 mL. The actual procedure of giving bladder Botox injections is
fairly simple. It will take less than 20 minutes, and is minimally invasive.
The procedure can be performed under local or general anaesthetic, and will not
require an overnight stay in hospital.
A cystoscope – a small
tube containing a camera – is passed into the bladder through the urethra so
that the surgeon can inspect the inside of the bladder before performing the
operation. A very thin needle is then passed through the cystoscope, and Botox
is injected into between 20 and 30 different areas of the bladder muscle walls
Thanks for sharing the information about the a boon for the patients with intractable urinary complaints .
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You are absolutely right Ramayaa. Now Botulinum Toxin can treat Neurological Disorders also.
ReplyDeleteBotulinum Toxin Clinic in Bangalore
Thanks for sharing nice information about what are the should effected while Botulinum toxin is effected. Great Blog!
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