Treatments Covered by Insurance
Marja Sprock, M.D. FACOG, FPMRS board
Insurance covered Botox®
treatment available at Central Florida UroGynecology in
What a great eye-catching
headline. Not only that, it is true. Caveat: it is in
the bladder and not in the face. Botox® is FDA approved
for the treatment of overactive bladder for
non-responders to medications in the group
anticholinergics. Anticholinergics are medications like
Oxybutynin, Tolterodine (Detrol®),Fesoterodine
(Toviaz®), Darifenacin (Enablex®), Trospium (Sanctura®).
These medications are taken in pill form, patches or
creams dependent on the specific medication used.
Botox® has been FDA
approved for overactive bladder since January 2013 and
for bladder problems in people with certain neurologic
conditions as spinal cord injury and multiple sclerosis
since August 2011.
Overactive bladder (OAB)
is a condition in which the bladder squeezes too often
and or without warning. Patients suffering from OAB
often know all the bathrooms on their way to work or map
them out. There is often a sudden urge/desire to
urinate, which sometimes leads to urine leakage. It is
the familiar you have the keys or doorknob in your hand
and notice urine escaping or you start leaking on your
way to the bathroom. Urination can also be frequent due
to a persistent urge feeling.
(onabotulinumtoxin A) in the face, which paralyses some
of the wrinkle forming muscles, Botox in the bladder
relaxes the Detrusor muscle. In overactive bladder, the
detrusor muscle is often overactive.
Injection of the
bladder with Botox is often done in an office setting
using a cystoscope. A cystoscopy is a procedure
which allows visualization of the inside of the bladder.
Most patients choose the convenience of the office to
have their Botox injected. They receive numbing
medication for the bladder and some antibiotics to
prevent a urinary tract infection (UTI). Risks of the
procedure are: UTI, that is the reason antibiotics are
given and a chance of retention. The chance of procedure
induced urinary retention is about 6%, which is in the
case of Botox®, a temporary inability to completely
empty the bladder.
The duration of the effect
of Botox® on the urinary incontinence in patients with
bladder overactivity is up to 10 months. Even though
there should be at least 12 weeks in between treatments,
it is usually between 6-9 months.
Botox can be used in
adults of any age. Edith, a very active, full of life
and activity 93 year old, had a debilitating overactive
bladder with leakage problem. Despite numerous
treatments, she required pads which she despised. Edith
came in after her Botox® injection for follow up. She
had done well and was emptying her bladder completely at
the correct time. “Guess what” she said, smiling ear to
ear; “I am just wearing panties.”
Dr. Marja Sprock,
one of the nation’s few board certified urogynecologists
(FPMRS) has treated numerous patients successfully with
Botox® in the bladder. If you have overactive bladder
and are not being helped by anticholinergic medications,
Botox may be an option for you.
Call Central Florida
UroGynecology in Rockledge 321-806-3929 or
www.CFUroGyn.com if you prefer to wear panties
instead of pads.