What to Expect: Botox Injection for Overactive Bladder (OAB)

19 Aug 2019 Blog

You’ve probably heard of Botox being used to improve the cosmetic appearance of facial wrinkles. However, botox has many medical uses that go beyond improving one’s appearance. For example, botox is commonly used to improve internal body functions. In the field of urology, it can be injected into the bladder muscle to improve symptoms of overactive bladder (OAB).

What is botox?

Botox is derived from the most poisonous substance known to man—botulinum toxin. This neurotoxin is produced by the Clostridium bacterium, responsible for botulism. Botulism is a rare but serious illness that can result in paralysis. Botulinum toxinwhen used in minute quantities in a derivative known as botox, is a magically effective and powerful potion.

How does botox work?

Botox is a neuromuscular blocking agent that weakens or paralyzes muscles. Beyond cosmetics, it can be beneficial for a variety of medical conditions that have some form of localized muscle overactivity. Botox is generally used to improve conditions with muscle spasticity, involuntary muscle contractions, excessive sweating and eyelid or eye muscle spasm.

Botox to treat Overactive Bladder (OAB)

Overactive Bladder (OAB) syndrome can be described by the symptoms of urinary urgency (the sudden desire to urinate), with or without urgency incontinence (urinary leakage associated with urgency). It’s usually accompanied by frequent urination during both day and night hours. OAB has been described as the “bladder squeezing without your permission to do so.”

When botox is injected into the bladder muscle, it treats the thick muscle bands, known as trabeculation. These are typically present in conditions that cause obstruction to the outflow of urine or bladder overactivity. By temporarily paralyzing a portion of the bladder muscle, OAB symptoms can improve dramatically.

The goal of botox in the bladder is to effectively treat persistent and disabling urinary urgency, frequency and urgency incontinence. Botox can be used to treat OAB for both males and females. It’s usually a plan B treatment for those who haven’t responded well or have been intolerant to bladder relaxant medications. Botox is FDA approved in the USA in a 100-unit-dose for OAB and 200-unit-dose for OAB associated with neurological conditions.

What to expect during a bladder botox injection

Bladder botox injection is a brief office procedure usually done under light sedation. It involves placing a cystoscope into the bladder and injecting botox into numerous sites in the bladder via a needle that fits through the cystoscope. The entire procedure takes about 10 minutes.

How to prepare for your bladder botox injection, and what to expect after the procedure:

  1. Stop blood thinner medications one week before botox injection
  2. Start antibiotics 2 days before and continue for 2 days after
  3. You may experience blood-tinged urine, burning with urination and pelvic pain for a day or so after the procedure.
  4. You may experience difficulty urinating and feel that you are not emptying completely. If so, you may require a catheter or learn how to temporarily do self-catheterization.
  5. It may take 1 -2 weeks to notice improvement. Although botox is highly effective, it’s not so in everyone.
  6. A follow up appointment with urinalysis and check of the post-void residual volume (how much urine is left in the bladder after voiding) will be scheduled for two weeks.
  7. Botox should last 6-9 months or so. After the improvement wears off, the injection can be repeated. If ineffective or only partially effective, the botox dosage can be increased.

Visit our locations page to find a urologist near you.

Written by Dr. Andrew Siegel

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