Botox is a neurotoxin produced by the bacterium, Clostridium botulinum, and related species. It has been refined to be a useful and powerful muscle relaxant in several medical disciplines. Perhaps the most well-known application is in plastic surgery, used to relax facial muscles, which cause wrinkles. Since about 2012 urologists have been using a Botox preparation to help relax bladder muscles for patients with refractory overactive bladder symptoms.

How is it done?

A diluted sterile preparation of Botox is injected into the bladder wall through a small sterile scope inserted under local anesthesia into the bladder. The 10-minute outpatient procedure uses a local numbing gel, followed by 15 to 20 one ml. injections in different areas of the bladder muscle. Most patients tolerate this well and do not require sedation.

Is it dangerous?

Careful studies were done before the FDA approved Botox for use in the bladder. It is very safe and effective. In a small number of patients, the bladder becomes over relaxed and urinary retention is possible. There can be a small amount of bleeding at the injection sites, but it generally is minimal and lasts less than a day.

What can I expect after the treatment?

There will be some early improvement with less overactive bladder symptoms, but the greatest benefit comes at about 1 week. Botox will remain active in the bladder wall for about 6 months and can then be repeated. There is no known limit to the number of treatments a patient may have. Botox is a good alternative for patients who are not able to take or did not benefit from oral medications.

When should I call the doctor’s office after the procedure?

  • Call for fever over 101 F
  • If you are have trouble with retaining urine
  • For burning stinging or foul odor to the urine
  • For bleeding more than light reddish urine