Overactive bladders get dose of Botox. (Refractory to Medical TX).

FORT LAUDERDALE, FLA.--Botox isn't just for wrinkles--it's for some overactive bladders, too.

Studies show that Botox can be an effective nonsurgical treatment for patients with overactive bladder who fail to respond to medical therapy, Dr. Sandip Vasavada said at a symposium on female pelvic floor disorders.

He said he uses Botox (botulinum toxin type A)--as opposed to Myobloc (botulinum toxin type B)--in the majority of such cases. Botox acts by blocking the binding of acetylcholine vesicles to nerve receptors, abolishing the extra motor contractions that occur in patients with overactive bladder.

He dilutes 300 units of Botox with 3 cubic centimeters of saline for a volume of 0.1 cubic centimeters per injection site. "We do a total of 30 injections throughout the bladder, 10 units per site, for 300 units.

The acetylcholine blockade will really only work in the local region you've instilled it in," said Dr. Vasavada, cohead of the section of female urology at the Cleveland Clinic Foundation.

He uses a small (3 or 5) French sheath needle that goes through the working channel of an ordinary cystoscope to cannulate into the bladder wall.

He also uses a lidocaine solution in the bladder.