Injections can help relieve the daily frustrations of urinary incontinence.
Urinary incontinence, or a sudden and unexpected loss of bladder control, is a common problem that can be either an occasional issue or a persistent problem. It’s when urinary incontinence reaches a point where it disrupts your daily life that it’s time to see a urologist.
If there are underlying conditions, such as a urinary tract infection or chronic constipation, treating those issues should help with the incontinence.
When the primary cause of UI is weak or loose bladder muscles or nerve damage that injections or bulking agents may be part of your treatment plan.
Normally recommended only when oral medications or topical creams aren’t effective, Botox (botulinum toxin type A) injections work by paralyzing muscles in the bladder. The outpatient procedure includes the use of an anesthetic gel to reduce sensitivity at the injection site. Patients will need to empty their bladder prior to receiving injections.
The most common way to administer Botox injections into the bladder is with a special lighted scope with a camera attached to it called a cystoscope. The scope is placed through the tube that carries urine out of the bladder (urethra). Sterile water is also pumped into the bladder to provide a better view of the area where the series of injections will be placed into the bladder wall.
Botox minimizes muscle contractions of the bladder to help with urination control. Intravesical Botox injections may be used to treat UI due to nerve damage or urge incontinence not linked to an underlying health issue or urinary problem. Possible side effects that may include burning sensations while urinating are usually temporary and mild. Drinking a sufficient amount of water following the procedure may minimize such effects.
Urethral Bulking Agents
Injections of bulking agents involve a synthetic material that’s placed into the urethra. The purpose is to increase the thickness enough to keep the urethra closed and minimize the risk of urine leaks.
Collagen is the most common type of bulking agent used with these injections, which may also be recommended when there’s a hole in the urethra that needs to be closed to stop leaks. Sometimes applied through the skin or the vagina in women, injections may also be used to increase bulk around the urethral sphincters that seal of the urethra from the bladder. A cystoscope helps with needle placement.
Patients may be asked to stand after injections are administered to determine if the leaks have stopped. If there are still leaks, another injection may be given.
When to Consider Injections
Urinary incontinence can be induced by stress from laughing, coughing, or lifting something heavy. This is called stress incontinence. If bladder leakage is primarily due to not being able to make it a bathroom on time, it’s referred to as urge incontinence. Botox injections and bulking agents may help with both of these forms of UI. Since injections don’t address the underlying cause of urinary incontinence, you’ll likely have a treatment plan that includes exercises to strengthen pelvic floor and bladder-supporting muscles and medications to calm your overactive bladder or relax bladder muscles.
Since injections may not be an effective long-term solution, a urologist sometimes suggests urethral or vaginal inserts or surgery for recurring urinary incontinence. Sling procedures or prolapse surgery may benefit women with stress incontinence, while men with urge incontinence might see positive results with an artificial urinary sphincter. Other treatment and management options include surgically implanted nerve stimulators that are similar to a pacemaker, the placement of a catheter, and the use of absorbent garments or pads.