Botox, the anti-wrinkle treatment which has been used to smooth away lines and firm up ageing bodies, now has a new use - as a cure for incontinence.
Doctors have pioneered a painless technique which involves injecting tiny quantities of the nerve agent into the bladder wall, to help people with the embarrassing and debilitating condition for whom other treatment has failed.
The news that Botox, beloved of celebrities and cosmetic surgeons, can help this less glamorous group of patients follows the discovery that it is also showing remarkable results in helping children who have cerebral palsy.
Prokar Dasgupta, the urological surgeon who developed the new bladder technique, said: 'We could be on the brink of an explosion in the use of this. It's remarkable that a poison which is derived from rancid sausages could turn out to have such an amazing number of applications. I think there will be many more to come.'
Botox first hit the headlines nine years ago when the treatment became available in cosmetic clinics across Britain. It works by temporarily firming up muscles that have become flabby. While many celebrities are still coy about admitting that they have succumbed to the craze, the comedian Joan Rivers has confessed that she began to have the jabs in Hollywood years ago. Actor Mickey Rourke was recently turned down for a film part because the producers feared his facial expressions had become immobile, which they blamed on the use of the agent.
But Botox, or botulinum toxin, which is derived from the bacteria that causes food poisoning, is now being put to a more serious medical purpose: 33 patients have so far been treated using Dasgupta's technique under a joint venture between Guy's and St Thomas's Hospitals and the National Hospital for Neurology and Neurosurgery in London.
Using a local anaesthetic, the surgeon inserts a thin telescope through the urethra, leading into the bladder, and then pushes a fine needle through the telescope to deliver one millilitre shots of Botox to 20 points on the bladder wall.
The Botox acts by blocking the action of acetylcholine in the wall of the smooth muscle, preventing the bladder from becoming overactive. 'This treatment is minimally invasive. It takes 15 minutes, and it appears to work for patients for whom other treatment, such as tablets has failed,' Dasgupta explained.
Some of his patients report a complete cure while others have found they need fewer toilet trips. All have recorded some degree of improvement. 'For many of these patients, their lives have become miserable. They can't go out to the shops or drive any more, and their quality of life is really quite poor. If Botox can be proved to help, that's great,' the surgeon said.
More data and understanding of how it works is needed before the technique becomes widespread. There is separate research being carried out to investigate how the neurotoxin acts chemically on the wall of the bladder.
Patients who undergo the treatment are also warned that it would need to be carried out again a year later, as eventually the effect of the injection wears off.
Doctors are increasingly finding a wide range of uses for botulinum, such as treating paralysis after a stroke, migraine headaches, back pain and even writers' cramp.
Last week specialists in Stoke-on-Trent, Staffordshire, revealed how they were using the anti-wrinkle treatment to help children with cerebral palsy. They have helped children, aged between 12 and 13, who have involuntary muscle movements, to perform everyday tasks, including walking.
In America, the treatment has been adapted to help patients who suffer severe headaches which do not respond to the traditional medications. The Botox is injected into the muscles around the eyes and forehead, and sometimes the jaw, and 84 per cent of patients reported improvements. However, there are concerns about its use becoming more widespread without long-term clinical data to show its safety and efficacy.
