What is Botox®?
Botox® is the brand name for a form of Botulinum Toxin. When injected into the bladder lining, it prevents/blocks bladder muscle contraction and can help with symptoms of urgency and urge urinary incontinence.
Who is suitable for Botox®?
Patients with a diagnosis of an overactive bladder who experience a strong urge to pass urine (associated with urinary incontinence) that do not respond to medication.
Patients with neurological problems causing an overactive bladder and/or high pressure in the bladder. Neurological conditions that affect the bladder include:
Spinal Cord problems
It is a well-tolerated procedure, but the effect is temporary, and further injections may need to be repeated after approximately 9 months.
Who is suitable for treatment with Botox®?
Men or women with the symptoms or problems mentioned above. Generally, patients should have gone through a series of other treatments such as bladder physiotherapy and/or bladder retraining, have tried oral medication for their symptoms and have failed these treatments before Botox® is considered.
How is Botox® given?
Botox® is injected over a wide area of the lining of the bladder as a number of small injections. A fine needle is passed through a cystoscope to allow injection and can be performed under local anaesthesia or under sedation.
After the procedure:
Most cases are performed as day case. Very occasionally an overnight stay is required. The effects of Botox® are not immediate, and can take 1-2 weeks to be noticed.
Because Botox inhibits the action of bladder muscle, it is possible that the effect may be too much for your bladder, and that you may not be able to pass urine normally for as long as it takes the effect of Botox® to wear off (this can be as long as 9 months). This is rare, but if it occurs, you would need to perform clean intermittent self-catheterisation (CISC) for this period of time.
Potential side effects and complications:
All procedures have the potential for side effects. Although these complications are well recognised, the majority of patients do not have problems after a procedure. These include:
A burning sensation and/or a small amount of blood in the urine for a short period afterwards
Urinary tract infection requiring antibiotics
The injection may not help your symptoms
Temporary insertion of a catheter if you are unable to pass urine immediately after the injection. You may then need to spend a period of time performing clean intermittent self-catheterisation (CISC)
Delayed bleeding requiring removal of clots or further surgery
Injury to the urethra causing delayed scar formation
Infection from the bladder causing sepsis
Allergic reaction to Botox®
If Botox® is inadvertently injected into a blood vessel; there is the possibility of effects on other organ systems.