Botox tegen incontinentie

[Thijs]

Botox helping incontinent men
By Janelle Miles
August 05, 2005

BOTOX injections, normally associated with smoothing out wrinkles, have a new purpose – helping incontinent men.

Sydney urologist Phillip Katelaris said men with Parkinson's disease, stroke or head injury sometimes developed incontinence via a condition known as overactive bladder disorder.

Dr Katelaris, of Sydney's Adventist Hospital, said the nerve control of the bladder was diminished in such patients.

He was speaking ahead of Continence Awareness Week which starts on Sunday.

Many men with urinary incontinence were continuing to endure the problem even though effective treatments were available, he said.

Although the most common treatment for men with overactive bladder disorder was daily drug therapy, botox injections were starting to be used on patients unable to take the medications.

"Just as botox injected into the face causes the muscle to relax and relieves wrinkles, botox injected into the bladder causes a partial paralysis of the bladder muscle and that can then relieve this urge incontinence problem that these men get," Dr Katelaris said in an interview.

"They go into hospital, have a light anaesthetic, we put a telescope into their bladder, then put a little needle into the bladder muscle and inject the botox.

"That's repeated every 12 to 18 months.

"But we don't go straight to botox injections. For most of these men we try the drug treatment first."

Anti-cholinergic drugs such as Ditropan and Detrusitol must be taken with caution in men who have glaucoma and can cause side effects like constipation and a dry mouth.

Dr Katelaris said botox injections gave urologists another treatment option.

He said the main risk was sometimes the bladder was switched off completely.

"If that happens, we have to teach the men how to pass a catheter into their bladders through their penises four times a day," Dr Katelaris said.

"It's not a hard thing to learn."

An estimated one in 10 Australian men have varying degrees of incontinence from a variety of causes, including the effects of prostate cancer surgery and benign prostate obstructions.

Treatments vary widely – including surgery and laser treatment – depending on the cause.

Pelvic magnetic therapy is also available for men who have undergone prostate cancer surgery to strengthen their pelvic floor muscles.

That involves men sitting in a specially developed chair twice a week for 20 minutes over three months.

"Men do not have to be wet," said Dr Katelaris, a director of the Prostate Cancer Foundation of Australia.

"Overwhelmingly, the problem can be fixed, or at least helped.

"The men who've got post-cancer treatment incontinence or the men who have incontinence related to benign prostatic obstruction, they can be definitively cured.

"The men who have neurological over-active bladder disorder can't be cured definitively but they can certainly be made very much better."

bron: the Australian 5-8-2005 (krant)