BOTOX for Overactive Bladder

You’ve probably heard of BOTOX® for removing wrinkles, but did you know that BOTOX® can be an effective treatment for bladder problems?

Until recently, patients with symptoms of overactive bladder, including urinary incontinence, urinary urgency, frequent urination and nighttime urination, were treated with a combination of behavioral coaching and medication. If these treatments didn’t work sufficiently, the patient would be referred for surgery.

A newer, less-invasive solution is now available: BOTOX® injections.

How is BOTOX® used to treat bladder dysfunction?

Botulinum toxin A (BOTOX®) causes muscle relaxation by blocking the release of neurotransmitters from nerve cells. Neurotransmitters are chemicals that signal muscle cells to contract.

During the procedure, local anaesthetic (freezing) is applied to the urethra and bladder and an instrument called a cystocope is inserted. A surgeon then injects BOTOX® into the wall of the bladder through the cystoscope. Approximately 100 to 300 units of BOTOX® are injected into the bladder. The procedure takes approximately 20 minutes, and patients are able to return home afterwards.

How long before patients see results?

It takes a few days for the effect of BOTOX® injections to be noticed. After which, patients typically notice improved bladder control, including less frequent need for urination, fewer and less severe episodes of incontinence and increased ability to hold the bladder. Improvements last from three to nine months before symptoms return, and BOTOX® treatments may be repeated. Current research indicates that 60 to 90% of patients experience significant symptom relief.

What are the risks?

Patients undergoing BOTOX® injections to the bladder may experience temporary urinary urgency and pain with urination. Approximately 6% of patients may require temporary self-catheterization to help empty the bladder.

Other possible complications may include:
  • Urinary tract infections
  • Blood in the urine
  • Muscle weakness
  • Allergic reaction

Where can I get treatment?

The Southern Alberta Institute of Urology offers BOTOX® injections for patients with symptoms of overactive bladder who fit treatment criteria. Ask your family physician whether you can benefit.

References

  1. Canadian Urological Association. The role of BOTOX® in treating overactive bladder. www.cua.org.
  2. Orasanu, B and Mahajan, S. The use of botulinum toxin for the treatment of overactive bladder syndrome. Indian J Urol. 2013. Jan-Mar: 29(1): 2-11.
  3. University of Michigan Heath System. BOTOX® A injections for urinary incontinence. Feb 2012. http://www.med.umich.edu/1libr/urology/BOTOX®AInjections.pdf.
  4. The Canadian Continence Foundation. BOTOX®. Emerging Technologies. www.canadiancontinence.ca.
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