For people who suffer from overactive bladder but don’t respond well to medication, Botox injections can significantly relax the bladder easing such symptoms. It is usually a well-tolerated procedure, but typically needs to be repeated every month.
Botox is the brand name for botulinum toxin. Botox is used to relax muscular tissue and is commonly used for wrinkles on the face. In the bladder, it can relax the bladder muscle. This results in a reduction in the need to visit the toilet as frequently as one did before.
This procedure is performed in patients with proven bladder over activity and urge incontinence or in patients with a neurological injury affecting bladder function. A cystoscopy is initially performed to assess the inside of the bladder. A series of small injections of Botox® is then injected into the bladder wall. The Botox® injections have the effect of partially ‘paralyzing’ the bladder, reducing the urgency and urge incontinence
The procedure is an out-patient procedure and can be done in the clinic in some cases. No special preparation is necessary. Botox can be given either when asleep ('general anesthesia') or with the bladder made numb ('local anesthesia'). Under a general anesthetic, a telescope examination of the bladder is performed ('cystoscopy'). The telescope is passed through natural passage ways in the bladder, so there are no incisions. The bladder is examined carefully. Botox is injected into the bladder wall through a special needle passed through the telescope directly. The bladder is emptied afterwards. Sometimes, a catheter is placed to empty the bladder - this is a small tube to drain the bladder that is removed on the ward.
Botox takes approximately 7 days to work after the procedure. Our goal is to see a 50% improvement in urinary symptoms after the injections – for example:
longer intervals of holding urine, less nighttime urination, less incontinence. It is rare that all symptoms will resolve. Botox treatments usually last between 3 and 6 months before the symptoms return. The procedure may be repeated when the symptoms return.