Botox therapy for overactive bladder

Botox (onabotulinumtoxin A) is a prescription medication which is injected into the bladder muscle to treat urinary leakage.   Botox is now approved for both urinary urgency and urinary frequency referred to as Overactive Bladder (OAB) as well as patients who have neurogenic bladder.

Overactive Bladder is when the bladder and brain do not properly communicate causing the message about voiding to be interrupted.  These interruptions lead to the bladder contracting involuntarily while filling which leads to urine leakage.   This therapy is appropriate for both men and women.

Before being scheduled for Botox Injection therapy the following will occur:

  • Medical evaluation by an urologist
  • Urodynamic testing if deemed appropriate and necessary
  • A trial on oral medication to see if your symptoms can be controlled before having the minimally invasive injection therapy
  • Discussion about your willingness and ability to do self catheterization if necessary
  • Stop all blood thinning medication (aspirin, etc) at least 3 days prior to your Botox Injection Therapy

On the day of the injection:

  • You’ll be asked to give a urine sample.  Botox cannot be injected if you have an infection
  • Have the procedure explained to you
  • Sign a consent form
  • Receive a local anesthetic to numb your bladder
  • Receive Botox injected in small doses into the bladder wall

After the injection:

  • You’ll be monitored for approximately 30 minutes
  • You’ll be given an antibiotic or a prescription for an antibiotic to take for 1-3 days
  • You’ll make a follow up appointment to see the doctor in 2-3 weeks.  Follow up appointments are important.  The follow up appointments are used to check the Post Void Residual.  The post void residual tells the doctor how much urine your bladder is holding after voiding.   The recommended amount is 200ml or less.  If the amount of urine being held in your bladder is too high your kidneys can be impacted negatively.

It normally takes 2-3 weeks to begin to recognize the full benefit of the Botox Injection Therapy.