Symptoms of overactive bladder are often linked to other medical conditions, such as neurological disorders, acute urinary tract infections or bladder irritations, as well as bladder abnormalities such as tumors or bladder cancer. In women, pregnancy and delivery can weaken the pelvic floor muscles, which is a common cause of overactive bladder. While in men, changes in the prostate gland often induce symptoms.

There are various medical treatments available for overactive bladder, but researchers believe that Botox injections may help patients when other medications have failed to relieve symptoms. According to a new study published in European Urology, patients who received Botox injections for overactive bladder experienced a decrease in both frequency and urgency.

British researcher Dr. Arun Sahai and colleagues at King’s College, observed 100 patients over the course of six years, receiving Botox injections for overactive bladder symptoms. Most patients were given between one and three injections. Injection rates varied because patients were given the choice to decide how many injections they received.

Twenty-five percent of patients discontinued their treatment after the first injection either because they did not feel relief of their symptoms or were uncomfortable with the need for self-catheterization after treatment. Of the patients who opted to continue treatment, researchers found continued improvement in symptoms of frequency, urgency and incontinence.

Researchers did note that 15 percent of patients experienced urinary tract infections (UTI) as a primary side effect of treatment. Botox injections have been seen to cause UTIs in other studies. The exact cause of this side effect is unknown, but researchers speculate that injections may cause bacteria to move deep into the bladder. Self-catheterization may also be a potential cause of these infections.

From the data collected, researchers were able to conclude that Botox injections for overactive bladder are both safe and effective for medium-term use. Long-term studies have not been conducted.

Learn more about Botox injections in Bellevue.

Source: Daily Rx

Just last year, more than 13 million plastic surgery procedures were performed in the United States, a five percent increase from 2009 according to the American Society of Plastic Surgeons (ASPS). This increase has caused speculation that more people are opting for plastic surgery to gain an attractive competitive edge in the dismal job market.

With significant declines in sales across the vast majority of industries, more and more plastic surgery clinics are offering plastic surgery specials and discounted rates. Ubiquitous companies such as Groupon, Living Social and Trubates, which offer daily deals to subscribers, are now allowing plastic surgeons to promote their practices by presenting potential customers with significant financial incentives. Common procedures such as liposuction, Botox and filler injections are now available at more affordable rates for the masses.

ASPS Concerned About Rise in Plastic Surgery Specials

While this may sound great to most plastic surgery candidates, plastic surgery specialty organizations such as the ASPS and the British Association of Aesthetic Plastic Surgeons (BAAPS) are concerned because there are no current provisions to regulate these types of deals and to protect patients from potentially unethical practices.

The ASPS and BAAPS realize that our current economic state makes it an ideal time for many to seek out cosmetic and plastic surgery procedures, but they advise patients to only seek out services from highly qualified plastic surgeons and to always be cognizant of the fine print on these discounted deals. A good deal on plastic surgery procedures is never worth sacrificing overall health and safety.

Learn more about plastic surgery specials in Bellevue, WA.

Sources: Healthcare Global

While there is no definitive evidence that using Botox to prevent wrinkles is effective, experts say that over the last few years there has been an increase in the number of 20-something patients who are getting Botox, Dysport and other injectables to try and ward off future wrinkles.

Statistics from the American Society for Plastic Surgeons show that in 2010 almost 78,500 people in their 20s received Botox in this country, an 11 percent increase from 2009.

So what do the doctors think? Plastic surgeon Arthur Perry thinks the concept of trying to prevent future wrinkles is “nutty.”

“You don’t want to use a drug unless you need the drug, and Botox is a drug,” he said.

Brian Glatt, a plastic surgeon, finds that regular use of Botox seems to make the muscle-relaxing effect last longer so patients don’t need to come in as often for treatments. This may occur because the muscle undergoes atrophy, or wasting, after prolonged periods of not being used, Glatt said, which could mean that wrinkles wouldn’t form as easily on a young person who has had treatments for years.

Also, if Botox is used regularly, the wrinkles that return when it wears off may not be as severe, said Glatt.

However, Perry feels that even if Botox was proven to prevent future wrinkles, it should not be used for that purpose. “It makes no sense whatsoever to do that,” he said.

Plastic surgeon Steven Pearlman goes by what you could call the “rest test.” He said to wait until lines show up before getting Botox. The wrinkles must be there when your face is at rest, not contorted through smiling or grimacing, he said. “Unless someone has lines at rest, they’re not a candidate for Botox.”

So how can you prevent wrinkles? Two of the best ways are to wear sunscreen and avoid smoking, according to the experts.

Dysport for Crow’s Feet: How Does It Fare?

The study, which was conducted at the University of California and published in the Archives of Facial Plastic Surgery, used 90 adults, mostly women, to compare their preference for Dysport or similar injectable Botox. Each patient was injected with 10 units of Botox on one side of their face at their crow’s feet, while the other side was injected with 30 units of Dysport for crow’s feet. None of the participants had ever undergone facial surgery, nor had they used a botulinum-based injectable in the previous six months.

One month after they had been treated, the patients were asked to compare their appearance with their facial muscles contracted to photos taken before being treated. According to the study, two-thirds of the patients said they preferred the wrinkle protection provided by Dysport for crow’s feet. With their faces relaxed, the patients generally noted no difference between the treatments.

How Does Dysport for Crow’s Feet Compare to Botox?

While for treating crow’s feet, Dysport may have garnered more patient preference, the authors of the study are quick to note that other injection sites on the face were not tested. For example, botulinum injectables are often used to treat forehead wrinkles, lines around the mouth and sometimes those signs of aging on the neck. Additionally, Dysport and Botox are not interchangeable and contain different formulations of botulinum, which should be considered when contemplating treatment.

When you visit your plastic surgeon for non-surgical wrinkle treatments, be sure to share your aesthetic goals so your plastic surgeon can suggest the best treatment for your needs.

Study researcher David R. Neal, PhD, a psychology professor at the University of Southern California, said, “If you have a poker face because your facial muscles are paralyzed, you can’t read others emotions as well.”

However, even Neal admits that it’s a “fairly subtle” effect. “People are not becoming automatons. It’s just a matter of weighing whether the aesthetic and self-esteem boost outweighs any subtle impact on your ability to perceive others emotions,” he added.

In the study, women who had their facial folds treated with Restylane were able to read others’ emotional states with about 77% accuracy, while those who had Botox had 70% accuracy.

Why would Botox have this effect and not other fillers? According to Neal, evidence suggests that people use mimicry to register and label the emotional states of others, so something that limits one’s ability to reproduce another person’s expression of emotions, such as Botox — which has a paralyzing effect on facial muscles in the immediate vicinity of the injection site — would likely impair one’s ability to register or label those emotions.

Andrew Jacono, MD, a facial plastic surgeon in New York City who reviewed the study, said that the findings likely only apply to those who use excessive amounts of Botox.

“When Botox is overdone, it doesn’t look right and people aren’t perceived in the right way,” Jacono said. “The goal is to try to make sure when you get Botox, it is done in a subtle way so you can look better and maintain your ability to emote and read others.”

“It’s a toxin-free alternative to treating unwanted lines and wrinkles, similar to what is being done with Botox and Dysport,” said study co-author Francis Palmer, director of facial plastic surgery at the University of Southern California School of Medicine in Los Angeles. He added that in the early clinical trials the procedure appears to have the same clinical efficacy and safety comparable to the existing techniques.

To perform the procedure, which takes about 15 minutes using local anesthesia, doctors use small needles that deliver cold to nerves running through the forehead. The cold freezes the nerve, which interrupts the nerve signal and relaxes the muscle that causes forehead lines. The technique does not permanently damage the nerve, Palmer said.

Researchers said they are still refining the technique but that the results last about the same amount of time as Botox, which works for about three to four months. However, unlike Botox, which takes a few days to kick in, the effects of the cryotechnology are seen immediately, according to the researchers.

The current study had 31 people, all of whom had fewer wrinkles after two to eight injections, and the level of discomfort was comparable to that from Botox or fillers, Palmer said.

If this new technique is eventually approved by the FDA, it would offer consumers an alternative to a neurotoxin injection for getting rid of forehead wrinkles. Statistics from both the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery for 2010 showed that Botulinum Toxin Type A, which includes Botox and Dysport, was the number one non-surgical cosmetic procedure.

The company will eventually seek FDA approval, but it might seek approval in Europe first.

Dr. Joel Schlessinger presented the findings at the American Society for Dermatologic Surgery 2010 Annual Meeting. His results were of a subset analysis of a phase 3 clinical trial designed to evaluate the effectiveness of Dysport.

An analysis of the Dysport group, made up of 1160 participants, found that 19.7 percent of the patients responded to Dysport on day one. Three days was the median response time to Dysport treatment. The study was not a comparative one with Botox; the other group was placebo.

“There are many different neurotoxins out there, and they have different types of effects on the injected individual, depending on the physical and molecular makeup of the neurotoxin,” said Dr. Schlessinger. He went on to say that Dysport appears to take effect faster than Botox, by about two days. “That can be very helpful for a person who is looking for a faster onset, especially if [he or she] has a social function coming up,” he said.

The “study that validates what clinicians have observed clinically with the use of [Dysport] with regard to its early onset of action in many patients,” said Dr. Elliot Weiss, from the Laser and Skin Surgery Center of New York in New York City.

Contact Dr. Leff at Overlake Plastic Surgeons to learn more about non-surgical options.

Migraines are three times more common in women than men and are characterized by intense pulsing or throbbing pain. Chronic migraine sufferers experience a headache more than 14 days of the month. While researchers are still exploring how Botox works on migraines, one theory is that it blocks pain signals from reaching nerve endings.

Current Botox worldwide sales are divided equally between medical and cosmetic uses, according to the New York Times. However, Allergan, the maker of Botox, believes its sales as a medical treatment may soon eclipse its sales as a wrinkle treatment. The injectable is also approved to treat uncontrolled blinking; crossed eyes; certain neck muscle spasms; excessive underarm sweating; and muscle spasticity in the hands and elbows.

Earlier this month it was reported that British scientists developed a way to refine Botox to improve its use for treating Parkinson’s, cerebral palsy and chronic migraine. The researchers’ method produced a refined Botox-like molecule, they said, which would be practical for clinical use but would not have unwanted toxic effects.

“It will now be possible to produce Botox-based medicines in a safer and more economical way,” said Bazbek Davletov, who led the study at the Medical Research Council’s Laboratory of Molecular Biology.

Davletov said the new refining technique could allow scientists to produce new forms of Botox with wider practical medicinal uses, for example as a long-term painkiller.

For more details, read the FDA press release on its approval of Botox to treat chronic migraine and the article on refining Botox, “Scientists Find Way to Refine Botox for New Uses.”

Patients in the early trials tended to see a moderate reduction in wrinkles around their eyes after using the product for a month. The product is being tested on crow’s feet because the skin around the eyes is thin and susceptible to bruising when Botox is injected.

While there are still about two years before clinical trials on the product, called RT001, are complete, plastic surgeons and dermatologists are already weighing in.

Potential Black Market?

Dr. David Colbert, a New York City dermatologist, told WCBS-TV that he worries that a Botox cream would be so popular that black market versions would be sold online without oversight and that the potential muscle paralyzing effects could be dangerous.

“I think it’s a brilliant idea, but I’m more concerned about the welfare of people who would use it irresponsibly,” he says.

The Holy Grail?

Dr. Scott Newman, a New York City plastic surgeon, feels the potential benefit is worth the risk. “It’s like the holy grail. If you can get a wonderful result with less downside, why wouldn’t that be an attractive option?”

For more than just wrinkles?

Dr. Anthony Youn, a plastic surgeon in Michigan, shared his thoughts about the product on his website: “I think a huge application of this topical botulinum toxin is in sweat reduction. Could you imagine an antiperspirant stick with this product that lasts several months with each application and leaves no residue? I’d buy it!”

To watch the WCBS-TV segment, go to http://wcbstv.com/video and search for “Botox cream.”

(before & after use of RT001 for 28 days; image via WCBS-TV)

In the United States, the FDA may decide later this month if it will allow Botox to be used for migraines, according to Aaron Gal, a Sanford C. Bernstein & Co. analyst in New York.

In the United States, in addition to treating wrinkles, Botox can be used to treat eye muscle spasms and muscle stiffness in the elbow, wrist, and fingers in adults with upper limb spasticity. There are also several off-label uses for Botox, such as treatment of excessive sweating.

Allergan’s clinical trial involved 1,384 adults who had a history of migraines and experienced 15 or more headache days of which at least 50 percent were migraine or probable migraine during the 28-day period. At the end of the baseline period, patients were randomized to receive either Botox injections or placebo.

By week 24 following treatment, those who received Botox averaged 8.2 fewer migraine days, compared to the placebo group, who averaged 6.2 fewer migraine days.

“We have been following these studies really closely and the evidence is really pretty solid. These people spend half their lives in pain. Even if they get half the attacks, it can really improve their quality of life,” said Lee Tomkins, director of Migraine Action in the U.K. She stressed it is not a cure but does offer hope for those who suffer from migraines.

Botox was the number one minimally-invasive cosmetic procedure in 2009, during which the procedure was performed 4.8 million times in the U.S., according to the American Society of Plastic Surgeons’ most recent statistics. Overlake Plastic Surgeons offers Botox to Bellevue and Seattle patients and is often able to schedule evening and same day appointments for the procedure.