Botox as treatment for overactive bladder

Overactive bladder is caused by an involuntary muscle contraction in the wall of the bladder. This condition of the bladder occurs mostly in women, but can occur in men also. Symptoms of an overactive bladder include:

• urgency of urination: having to pee right now
• frequent nighttime or daytime urination: having to urinate often
• urinary incontinence: accidents or leaking urine

Overactive bladder can interfere with your work, social life, relationships, exercise routine and sleep. The good news is this condition is very treatable.

Overactive bladder treatments

Treatments for overactive bladder try to reduce or eliminate the muscle contractions or spasms in the wall of the bladder.

• lifestyle modifications: healthy weight, limit alcohol and caffeine intake
• pelvic floor physical therapy: restoring strength and function to pelvic floor muscles
• oral medications
• Botox injections
• sacral neuromodulation (like a pace maker for the bladder)
• posterior tibial nerve stimulation (using stimulation at the ankle to improve bladder function)

Symptoms are often persistent and may not respond to more conservative treatments. When these treatment options don’t relieve symptoms, this is when Botox may be an appropriate treatment option for you.

Botox injections for overactive bladder

You may be most familiar with the use of Botox (Onabotulinum toxin A) in the cosmetic market for antiaging, wrinkle reduction on the skin of the face. However, Botox is an FDA-approved treatment for overactive bladder that is well tolerated and highly effective.

Botox is derived from a bacterial toxin called Clostridium botulinum, and is used in very minute amounts to treat several muscular conditions by temporarily relaxing, or paralyzing muscles.

In most cases, women will experience noticeable changes in urinary symptoms about a week after the Botox injection. And most women experience a 60 – 90 percent improvement in symptoms.

The Botox is not intended to be a permanent treatment, as it does wear off slowly over time, typically in about four to 12 months. When your bladder symptoms come back, you can repeat the Botox injections.

What to expect during Botox bladder treatment

During a bladder treatment, the Botox is injected directly into the muscle of the bladder using a thin telescopic lighted camera (cystoscope) that goes through the urethra, which is the tube you pee out of. This procedure can be done in the office and does not require a trip to the operating room, an IV, sedation, or any time off work and/or hobbies to recover. The treatment takes about five minutes to do, but you will likely be at the doctor’s office for about an hour in total.

Side effects of Botox in the bladder

Botox treatments are typically very well-tolerated. The day after the treatment, you may experience some burning with urination, or see a small amount of blood in the urine. The most common side effect of using Botox for overactive bladder is a urinary tract infection. About four to eight percent of patients will be unable to empty their bladder and need to use a small catheter to empty their bladders throughout the day, until the medicine wears off and urination resumes.

Who offers Botox injections in the bladder?

When conservative treatment options aren’t relieving your symptoms, then seeking care from a urogynecologist for Botox in the bladder may be the next best step. A urogynecologist is an OB/GYN specially trained to care for the muscles, tissues and organs in a woman’s pelvic area.