This study shows that repeated injections of botulinum toxin into the detrusor muscle* of the bladder in PwMS, who have refractory over-activity of their bladders, leads to a consistent effect on bladder control and, importantly, results in sustained improvement in quality of life.
* "The detrusor muscle is the balloon-like muscle that relaxes when the bladder is filling and contracts when the bladder is emptying. In MS the detrusor muscle is typically overactive leading to a small contracted bladders (low volume or small balloon) that is irritable. The combination of these effects results in patients complaining of urinary frequency and urgency. Multiple botulinum toxin injections into the detrusor muscle relaxes the muscle, which increases the volume of the bladder and reduces the irritability of the bladder. As the injections into the bladder wall have to be done using a flexible scope under direct visual guidance the procedure and treatment are relatively expensive."
Khan & Fowler et al. J Urol. 2011 Apr;185(4):1344-9. Epub 2011 Feb 22.
I used to work with Professor Clare Fowler who led this study; she was a very caring and thoughtful neuro-urologist who pioneered this treatment. One of my MS heroes!