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Saint Barnabas Urologist uses Botox Injections to Help Those With Overactive Bladder Livingston, N.J .-- Urologist Yitzhak Berger, M.D., a nationally recognized expert in the field of urinary incontinence and bladder dysfunction, has been successfully using injections of Botox to treat overactive bladder (OAB). Dr. Berger, a principal investigator in a clinical trial, has found that patients who were treated with injections of Botox into their bladders have experienced a marked decrease and/or complete resolution to their symptoms of urinary frequency, urgency and urge incontinence. Botox injections are known mostly for their use in cosmetic treatments. When injected into the wall of the bladder they result in partial paralysis of the bladder muscle (detrusor), preventing its involuntarily contractions that cause the sudden need to urinate and incontinence that occurs among patients with OAB. “The dosages that we are administering are safe and highly effective for the most complicated cases of OAB,” says Dr. Berger, an attending urologist in Saint Barnabas’ Department of Surgery as well as an attending physician for the Department of Obstetrics and Gynecology. “It is very gratifying to see patients who previously could not function well or engage in social activities because of their symptoms, now being able to resume a normal life.” The treatment could help an estimated 1 in 11 adults in the U.S. who suffer from OAB. While a variety of medications for this condition are available, they are associated with significant side effects such as dry mouth, dry eyes, changes in heart rate and constipation. Many patients find these side effects find to be intolerable and it results in the discontinuation of the OAB medication and living with their bladder symptoms. For those with more advanced OAB symptoms, the higher dosages of medication needed to treat their urinary problems may result in even more severe side effects. It is estimated that approximately 17 to 30 million adults in the U.S. suffer from some form of urinary incontinence. However, because of personal and social reluctance, many do not report their disorder to their physician so the actual incidence may be much higher. Women account for approximately 75 percent of the cases. Dr. Berger is an investigator in a study that evaluates the efficacy of Botox among patients with OAB who do not suffer from any neurological conditions. However, Botox could also be used to treat the thousands of people who develop OAB as a complication of neurological disorders, including multiple sclerosis and spinal cord injury. A separate study to evaluate the effect of Botox in these patients is about to begin and Dr. Berger’s site is now enrolling eligible patients. Biannual Botox Injections Provide Relief Botox injections to treat OAB have been used in Europe since the middle and late 1990s, reports Dr. Berger. The doses that are injected into the bladder are safe, highly effective, and administered through a cystoscopic examination during an office visit using local anesthetic. Cystoscopy is a test that allows the doctor to look at the interior lining of the bladder and the urethra. The cystoscope is a thin viewing instrument that is inserted into the urethra and advanced into the bladder. Twenty minutes before the injection, Dr. Berger introduces fluid through the cystoscope which numbs the area. Then, using an injectable syringe through the scope, he performs the injection. The injections into the bladder are not painful and each treatment requires about 10-15 minutes. The reported side effects following these treatments are mild (minimal bleeding after the first urination and temporary inability to pass urine) and they may occur in 2-3 percent of the patients. These office treatments need to be repeated approximately twice a year. While the Food and Drug Administration has not yet approved this treatment for OAB, it is under consideration and Dr. Berger expects approval to come in about a year. The two clinical trials he is conducting are being performed to establish dosages standards and guidelines on the injections. So far all of his clinical trial patients, each of whom was previously taking high doses of OAB medication, have reported an absence of incontinence and a return to life before OAB symptoms. None of the patients reported any serious side effects or complications. Barbara Sweeney of Whippany, N.J., lived with OAB symptoms for 18 months, thinking it would “all go away” eventually. “I always needed to know where the bathrooms were and be concerned about getting there in time. It just did not make me happy,” she relates. When the problem persisted, she went to Dr. Berger for treatment. For a year she took medication which helped with the symptoms, but did not completely eliminate the problem, and she also experienced some medication side effects. When Dr. Berger told Ms. Sweeney about the new Botox clinical trial, she was enthusiastic to try it. To her amazement and joy, after the procedure in September 2006 she was completely symptom-free for many months. “It alleviated the problem completely,” she says. “It is absolutely wonderful to be carefree again. To anyone considering the treatment, I would say, you know what your life is like now, and what it was before the problem. Through this procedure you can be like you were again.” Although some insurance companies may not cover the procedure before FDA-approval, Dr. Berger believes that many patients suffering from OAB may not want to wait to receive relief through treatment. Dr. Berger has a practice primarily composed of female patients or both genders with voiding dysfunction. For more information about this procedure, please call Dr. Berger’s office at (973) 325-6100. March 27, 2007 [ top ] |
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