Who Would've Thought Botox Could Cure Bladder Pain?

Zeeshan Qazi

Dr. Frank Tu’s article, A Noninvasive Bladder Sensory Test Supports a Role for Dysmenorrhea Increasing Bladder Noxious Mechanosensitivity, described many of the implications new diagnostic methods for bladder sensitivity can hold. Currently, interstitial cystitis or bladder pain syndrome, and overactive bladder affect approximately 20% of women in the US. IC/BPS and OAB are highly prevalent health problems affecting many people. For example, dysmenorrhea which is pain caused from menstruation, can lead to increased sensitivity in the bladder as well.

Common methods of testing bladder sensitivity and pain involve catheterization which can add to the existing pain. The catheter inside the urethra causes external stimulation which can alter the results retrieved from the tests. However, Dr. Tu used sonographic ultrasound tests of the bladder using 2 and 3 dimensional imaging to provide a better result of bladder sensitivity. He had his participants describe the sensitivity of their bladder by the urge to urinate in either first sensation, first urge or maximum tolerance. Using the new sonographic test, the total bladder volume was observed. It was found that bladder sensitivity increases as a result of bladder volume and even more so when a woman is experiencing dysmenorrhea.

Sensitivity and bladder volume are related to overactive bladder. When bladder sensitivity is increased, the urge to urinate occurs at a lower than normal bladder volume. A person with OAB will experience contractions of their bladder muscles too often, stimulating their urge to urinate. The FDA has published an article outlining their decision to approve the drug Botox to be used to help alleviate the symptoms of OAB.

Botox, also known as onabotulinumtoxinA, is a toxin in the class of anticholinergics which works on the effects of the neurotransmitter acetylcholine (ACh) and its cholinergic receptors. It binds to receptors inhibiting neuronal signals to muscles disabling them from being able to contract. Similar to its intended use in cosmetic procedures, it is used to relax muscles to ease out wrinkles. When used in the bladder, the muscles relax and as a result, the bladder volume increases, decreasing the pressure lessening the urge to urinate. This can also help alleviate any pain on the bladder because pressure is released on the bladder sensory receptors.

12 weeks of testing done by the FDA has shown results that confirm its efficacy in patients with overactive bladder. However, some of the side effects of using Botox are urinary tract infections, and urinary retention which may require the use of a catheter. The results from Dr. Tu’s research can help us understand the effects of Botox on the bladder. Further research into how Botox functions can help us understand its uses for other ailments in the future. This field of study has the potential to grow and help us in many ways.
                                                                                                                                                                 

Works Cited

Tu, F. F., Epstein, A. E., Pozolo, K. E., Sexton, D. L., Melnyk, A. I., & Hellman, K. M. (2012, October 1). A Noninvasive Bladder Sensory Test Supports a Role for Dysmenorrhea Increasing Bladder Noxious Mechanosensitivity. Clinical Journal of Pain, 29(10), 883-890. https://luc.app.box.com/s/4c031c26bsh2bj3619si/1/2387647111/20468164837/1

Yao, S. (2013, January 13). U.S. Food and Drug Administration. Retrieved December 10, 2014, from http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm336101.htm