Botox shows potential for bladder spasms and leakages

Dec 5 2007

Eight years ago, Lynette Kunz suffered a severe spinal cord injury that left her a quadriplegic and sufferer of involuntary bladder contractions.

The condition constantly interfered with her daily life.

“I can somewhat detect when my bladder is full, but I have a much shorter time span for getting to the bathroom than someone with a normal bladder,” said Ms. Kunz, 42. “I could not sit down for an entire meal at a restaurant because I was in constant fear of suffering an embarrassing incident.”

Now, thanks to a procedure performed at UT Southwestern Medical Center, Ms. Kunz has regained control of her bladder by receiving injections of botulinum toxin A, commonly known as Botox.

The treatment, being administered by Dr. Gary Lemack, associate professor of urology, consists of injecting Botox into numerous sites in the bladder. The toxin blocks the release of the chemical that causes the muscles to contract. Although the treated muscles become paralyzed or weakened, other muscles are unaffected and can function normally.

“Damaged nerves may send signals to the bladder at the wrong time, causing its muscles to squeeze without warning,” said Dr. Lemack. “The Botox prevents the bladder muscles from having these spasms that lead to urinary frequency and urgency. The treatment will vastly improve bladder function in the majority of patients for a period of six to nine months.”

Botox has been used by physicians internationally to treat conditions in the lower urinary tract, but the therapy has not been approved officially in the U.S. by the Food and Drug Administration. Over the last five years Dr. Lemack has treated nearly 40 patients with the drug and has taught postgraduate courses on its potential uses.

He is currently conducting a Botox clinical trial, the results of which could impact future FDA determinations concerning the drug's usage for urological conditions. The research at UT Southwestern is being funded by Allergan, which manufactures Botox.

Dr. Lemack said the treatment is promising and offers hope for patients like Ms. Kunz.

“I was not interested in undergoing invasive bladder surgeries to relieve my condition,” Ms. Kunz said. “I'm independent to a degree; that's very important to me. I am a mother and extremely active in my community. The treatments have ensured spasms and leakage won't slow me down, and I'm thankful to be receiving these injections from Dr. Lemack. I'd definitely recommend Botox for someone in a situation similar to mine.”