Better Treatment for Bladder Problems in people with MS, UK

New research funded by the MS Society has shown that Botox injections to the bladder provide benefits for people with multiple sclerosis (MS) with sustained improvements to their overall quality of life.

Bladder problems are a common and disabling symptom of MS where both storage and emptying processes can be disrupted. Incontinence is common and being unable to 'hold on' (known as urgency) is understandably considered by many people with MS to be one of the most troubling symptoms they face.

In the recent research, carried out at the National Hospital for Neurology and Neurosurgery, 43 people with MS who had severe incontinence problems were treated with botulinum neurotoxin type A (Botox) bladder muscle injections. The action of the injection on the bladder is complex but its overall effect is to reduce involuntary contractions and so reduce frequency of urination and urgency.

The £200,000 study showed significant improvements in incontinence episodes and the frequency of urination both day and night. There were also sustained improvements in all quality of life measures used and frequency of urination returned to near normal.

Dr. Laura Bell, Research Communications Officer for the MS Society, said: "Living with symptoms such as bladder problems can be extremely distressing and restrictive, but this type of treatment can make a tangible and substantial improvement to people's lives and we hope it will become part of standard care for people with MS who need it."

The typical duration of the effect of the treatment was 10 months and similar results were seen with repeat treatments.

This treatment is not yet licensed in the UK and is consequently not yet widely available for people with MS.

Professor Clare Fowler, Consultant in Uro-Neurology at The National Hospital for Neurology and Neurosurgery said: "This study was done as part of a research investigation and the treatment is not widely available. This is because bladder injections of Botox have not yet been licensed and although studies by the pharmaceutical company are ongoing it will probably take a few more years.

"This research has been extremely valuable in establishing a clinical method, researching why the treatment works so very well, and providing an opportunity to demonstrate the minimally invasive injection technique to more than 60 visitors, mostly UK consultant urologists, who attended as observers."

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