City pioneers use Botox to fix bladder problems
PIONEERING surgeons are using the beauty treatment Botox to cure bladder problems in multiple sclerosis patients.
Until now the procedure, which involves injecting botulinum toxin, has been used to reduce lines and wrinkles.
However, at Edinburgh's Western General Hospital, it has dramatically reduced incontinence among MS patients, and it could now be trialed on other people who suffer from bladder complaints.
Doctors have been injecting tiny quantities of Dysport, a brand of botulinum toxin, directly into the bladder wall.
The procedure has cured the bladder problems in 90 per cent of patients, and its effects reportedly last between nine to 12 months.
The research team, which includes consultant urological surgeon Laurence Stewart, consultant gynaecologist Kate Patrick and research fellow Steven Finney, claims most patients have been able to stop using or reduce medication for their bladder problems.
Mr Stewart said studies in other countries had shown botulinum toxin could help patients with incontinence caused by nerve problems, but they wanted to explore the benefit for patients with MS.
"We thought MS is a big problem in Scotland, and they are a very deserving bunch of people for whom there isn't a lot of help," he added. "A significant proportion of them have bladder problems."
The team recruited 20 patients who had been diagnosed with MS by a neurologist and suffered from an overactive bladder.
They were then selected at random to receive either the toxin or placebo injections under local anaesthetic.
While this study only looked at MS patients, Mr Stewart says a similar treatment could help other people who are incontinent.
"It is as applicable to patients who have got what we call idiopathic over-activity. These are patients for whom we don't know the cause (of their incontinence) and they are a bigger group."
Discovered in German sausages in the 18th century, botulinum toxin is released by the clostridium botulinum bacteria, and causes the form of food poisoning called botulism.
It was considered as a potential biological weapon in the Second World War, but plans to use it in poison pills were abandoned after tests on mules showed it had no effect. It was later discovered that mules are the only animals that are immune to the toxin.
Currently Botox and Dysport are not licensed for the treatment of bladder problems, but Mr Stewart believes the research to date shows there is a benefit, and the patients who took part in the trial are being offered further injections.
"Potentially, patients could be injected and then re-injected once per year, which would make it a manageable cost," he said.
"Incontinence costs the nation quite a lot of money, because these patients take time off work and there is a loss of revenue. There is also a significant cost in supplying pads for these people and other medications."
Depending on what people drink, on average people will need to pass water seven times a day. But incontinence affects almost one in five of the population and is more common among men than women. Mr Stewart said: "It is a big, big problem - about 17 per cent of the population have got overactive bladder symptoms. In terms of prevalence, it outstrips diabetes and asthma and cardiac problems, but because it is not life-threatening, it is not perceived as a big problem - unless you've got it.
"The classic comment I get from a patient is that 'it may not have killed me, but it has stolen my life away'."
One female MS patient, Lee Robertson, 34, from Edinburgh, said: "It has made a huge difference to my life. It was great to be in control again - I couldn't control my bladder, it was controlling me.
"Now I can go to the pictures or the theatre and relax and enjoy the film. I tell my friends my bladder is ten years younger than the rest of me."
Source: The Scotsman.com ©2006 Scotsman.com