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Botox Dose For Overactive Bladder

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Botox for the Treatment of Overactive Bladder

If you suspect that you have OAB, you should discuss treatment options with your doctor. While Botox is undoubtedly an advantageous choice, this treatment plan is usually chosen if other medications do not work.

Now, people have another option for relief of symptoms that interrupt their daily life. Speak with your doctor to learn more about the best treatment option for your situation.

How Much Does Botox Injections Cost

Most health insurance plans cover medical Botox treatment under FDA approval. Usually, the dosage of 155 units costs around $300 to $600 for each treatment.

Medicares injection cost may vary depending on plan coverage, medical condition, and the type of injection. Most plans have coverage for chronic migraines.

Contact your plan before getting any Botox injections. Ask your insurance provider if you need any paperwork for Medicare coverage to apply.

What To Expect: Botox Injection For Overactive Bladder

Youve probably heard of Botox being used to improve the cosmetic appearance of facial wrinkles. However, botox has many medical uses that go beyond improving ones 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 .

What is botox?

Botox is derived from the most poisonous substance known to manbotulinum 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 toxin, when 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

Overactive Bladder syndrome can be described by the symptoms of urinary urgency , with or without urgency incontinence . Its 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.

Don’t Miss: Hard To Urinate When Bladder Full

Botox For Overactive Bladder Urgency Incontinence And Neurogenic Lower Urinary Tract Dysfunction:

Botox injection into the bladder is a well-established treatment for overactive bladder and urgency incontinence, including urgency incontinence associated with neurological disease. It is usually used when behavioral and exercise therapies and medications have not been effective in treating symptoms. Botox has been shown to produce dramatic improvements in symptoms and quality of life in women who have not responded to or could not tolerated other treatments. At the Center for Women’s Pelvic Health at UCLA, our physicians did some of the pioneering work on use of Botox for overactive bladder and incontinence over the past 15 years. In most cases Botox can be done in an office setting with local anesthesia instilled into the bladder.

Does Medicare Cover Botox For Migraines


Yes, Medicare covers Botox for migraines, although its not intended for individuals who endure less than 15 days of headaches in a month. The FDA approves Botox for chronic migraines as an effective treatment. Headaches lasting 15+ days of the month are known as migraines.

Dr. Andrew Blumenfeld, Director, The Headache Center of Southern California, says:

The more frequent the headaches, the better the patient does with Botox.

Look for a neurologist or headache specialist that accepts your plan if you are considering Botox treatment.

Also Check: Causes Of Weak Bladder Control

What Does Treatment With Botulinum Toxin Involve

Treatment with Botulinum toxin involves a day case procedure in hospital or a day procedure unit with the use of either general or local anaesthesia.

The recommended dose of Botulinum toxin for OAB is 100 Units whereas the dose recommended in people with neurological problems is 200 to 300 Units.

A cystoscope is passed into the bladder through the urine pipe and is used to inject the solution of Botulinum toxin. Tiny amounts of diluted Botulinum toxin solution is injected directly into about 20 to 30 locations inside the bladder muscle using a fine needle.

Muscular wall of inside of a bladder due to OAB.

Botulinum toxin solution is injected directly into the bladder muscle using a fine needle under guidance of the cystoscope.

Bladder appearance immediately after injection with Botulinum toxin solution.

The procedure has minimal side effects and patients are discharged home quickly after the procedure.

It is important to realise that the effects of the treatment with Botulinum toxin are NOT immediate and become apparent within 1 to 2 weeks.

A review appointment is made within 1 to 2 weeks after the treatment with Botulinum toxin to check bladder emptying .

Onabotulinumtoxina For The Treatment Of Overactive Bladder

Accepted for publication 5 June 2014

21 July 2014Volume 2014:6 Pages 7989

Supplementary video showing injection technique.

Views: 2356

Lindsey Cox, Anne P Cameron Department of Urology, University of Michigan, Ann Arbor, MI, USA Abstract: OnabotulinumtoxinA injection is a safe and effective treatment for adults with refractory overactive bladder. There is sufficient level 1 evidence to support offering onabotulinumtoxinA injections as a second-line treatment to patients who have failed behavioral therapy and oral medications such as antimuscarinics and 3 agonists. An intradetrusor injection of 100 U of onabotulinumtoxinA is likely the optimal dose to balance risks and benefits, and this is the dose approved by the US Food and Drug Administration. Improvement in urgency urinary incontinence episodes, as well as symptom scores and quality of life, were seen in around 60%65% of patients, and were significantly improved compared with those on placebo. Most studies have reported a duration of symptom relief ranging from 6 to 12 months, with repeat injections being safe and efficacious. Overall, the risk of urinary retention was around 6% across the study populations. Keywords: urgency urinary incontinence, urinary retention, nocturia, frequency


Results for onabotulinumtoxinA in OAB

Injection technique

Repeat injections

Long-term use

Complications and their management


Read Also: Treatment Of Overactive Bladder In Males

What Are The Side Effects Of Botox

The lists below include some of the main side effects that have been reported in people using Botox. For information about other possible side effects of the drug, talk with your doctor or pharmacist.

You can also learn more about side effects from this in-depth Botox article or from the drugs medication guide.

Note: After the Food and Drug Administration approves a drug, it tracks and reviews side effects of the medication. If youd like to notify the FDA about a side effect youve had with Botox, visit MedWatch.

What Are The Risks And Benefits Of Botox For Overactive Bladder

Botox for an Overactive Bladder — The Doctors

Most overactive bladder treatment works in about 65% of women. This is true for botox as well. Botox minimizes bladder symptoms in 65% of women for 6-12 months. It completely cures women in about 30% of women. It wears off over time but can be repeated. Common side effects are urinary tract infections and trouble emptying . Most women are very satisfied with this treatment and it increases quality of life across all health scales in studies. I have patients who come in for their bladder botox every six months like clock-work.

Botox does not have many side effects which increases its appeal. The side effects are all bladder related which is very different than medications. There is no associated dry mouth, dry eyes or constipation. And you dont have to remember to take it everyday. It is a great option to have available. If you are interested in learning about all of the overactive bladder treatments, check it out here.

Lucacz ES et al. Urinary incontinence in women: a review. JAMA 318:1592-1604.

Nui H-L et al. Comparison of onabotulinumtoxinA vs sacral neuromodulation for refractory urgency urinary incontinence: A systematic review and meta-analysis of RCT. Int J Surg 2018 60:141-8.

Nitti VW et al. OnabotulinumtoxinA for the treatment of patients with overactive bladder and urinary incontinence: results of a phase 3, randomized, placebo controlled trial. J Urol 2017 2S:S216-23.

Also Check: What Causes An Overactive Bladder In Males

How Much Does Botox Cost

The price of Botox depends on several factors. These can include your treatment plan, your insurance plan, the pharmacy you use, and your location. For estimates of how much Botox costs, visit

Currently, Botox is only available as a brand-name medication. Its not available in a generic form.

Talk with your doctor about using Botox for your bladder condition. They can help determine if Botox might be a good fit for you.

Here are some examples of questions you may want to ask your doctor:

  • Can I receive Botox injections if I have a urinary tract infection ?
  • After receiving my Botox injection, when will I see results?
  • Does Botox interact with any other medications Im taking?
  • Can I receive Botox injections for bladder problems if Im pregnant?

What Is The Typical Dosage For Botox

Below are commonly used dosages of Botox for bladder conditions. But your doctor will determine the right dosage to fit your needs.

For OAB symptoms in adults, the recommended dose is 100 units of Botox. This is also the maximum recommended dose for treating this condition.

For use in adults with detrusor overactivity caused by a neurological condition, the recommended dose is 200 units of Botox. This is also the recommended maximum dose for treating this condition.

Childrens dosage

Botox is used in children ages 5 years and older with detrusor overactivity caused by a neurological condition. For this purpose, the Botox dose is determined based on the childs weight:

  • For children who weigh at least 75 pounds , the dose is 200 units of Botox.
  • For children who weigh under 75 pounds, the recommended dose is 6 units of Botox for every kilogram of body weight. Your childs doctor will calculate the appropriate dose for them.

Note: Botox has other uses in addition to treating bladder problems. The dosage may be different for these other uses. To learn more, talk with your doctor.

Recommended Reading: How Can I Relax My Bladder Naturally

Different Injection Number Of The Same Dose Of Botulinum Toxin A On Overactive Bladder Syndrome

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
First Posted : August 6, 2012Last Update Posted : February 15, 2017
  • Study Details
Condition or disease
Drug: BoNT-A Drug: BoNT-A Drug: BoNT-A Phase 2

This study was designed as a single blind, randomized, parallel, actively controlled trial. The urodynamic DO confirmed patients were randomly assigned to receive injection of onabotulinumtoxinA 100 U , which was reconstituted to 10 ml with normal saline for suburothelial injections, in one of the three groups with the following injection number: 100 U in 10ml injections, 1.0ml for each injection, totally 10 injections at bladder body 100 U in 10ml, 0.5ml for each injection, totally 20 injections at bladder body, 100 U in 10ml, 0.25ml for each injection, totally 40 injections at bladder body. Permuted block randomization was used for this trial. All treatments were evaluated at baseline and the primary end-point at 3 months.

Inclusion Criteria:

Exclusion Criteria:

Information from the National Library of Medicine

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 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 doctors office for about an hour in total.

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Who Should I See About Botox For Oab

As with all advanced therapies for Overactive Bladder, there are advantages in meeting with a specialist in bladder health to treat refractory symptoms. A doctor who has training and experience in bladder disorders can perform a comprehensive evaluation to be sure that the symptoms are actually caused by Overactive Bladder. Other bladder disorders can result in frequent urination, urgent urination and urinary incontinence. If a patient is not responding to therapies such as behavior changes and medications, it may be beneficial to pursue a more in-depth evaluation to confirm the diagnosis, especially before proceeding to advanced therapies. Patients who have something blocking their bladder, for instance, could be made considerably worse by injecting Botox.

Treating refractory OAB with a bladder specialist may also offer more options to patients. Someone who focuses on bladder health will be able to offer all of the advanced therapies for OAB insuring that you are able to choose the therapy that best fits your needs.

Important Safety Information Contraindications

BOTOX® is contraindicated in the presence of infection at the proposed injection site and in patients who are hypersensitive to any botulinum toxin product or to any of the components in the formulation.

BOTOX® is contraindicated for intradetrusor injection in patients with a urinary tract infection, or in patients with urinary retention, or post-void residual urine volume > 200 mL who are not routinely performing clean intermittent self-catheterization .

Read Also: How Long Can You Live With Aggressive Bladder Cancer

What Can I Expect After Receiving Botox Injections For My Bladder Problem

After receiving a Botox injection, you may have improved bladder control for about 12 weeks. Some people may still have bladder control after 24 weeks. After this period, the effect of Botox wears off, and youll need more injections.

Your experience with Botox injections may vary. If you have questions about the results you can expect with this drug, talk with your doctor. And for more information, see the How effective is Botox? section below.

Injection Modes And Sites

Botox can treat overactive bladder

Botulinum toxin injections have been described to be delivered to different tissues along the lower urinary tract. In the bladder, literature investigated both intravesical instillations and intradetrusor injections, with the latter proving to be more effective in achieving the therapeutic effect of botulinum in the bladder. BoNT-A can also be delivered intrasphincterically to the urethral sphincter, either periurethrally or even transperineally as some research describes, as well as injected into the prostate.

Literature and guidelines alike have described different numbers of injection sites in a technique called mapping. This entails injecting the toxin in a well-spread manner to a specific number of sites on the cystoscopy. Of recent, the most commonly utilized number of injection sites varies between 20 and 30 mapped sites, equally spread between the right and left posterolateral walls of the bladder, with some sites injected more caudally. However, there has been an avoidance for injection of botulinum toxin in the bladder trigone as hypothesis suggests it may contribute to the development of retrograde ascension of urine from the bladder to the kidney, known as vesicoureteric reflux. The consensus is out on whether this hypothesis is valid however, trigonal injections have been applied in botulinum injections for bladder pain syndrome/interstitial cystitis with no reported occurrence of reflux .

Recommended Reading: What Does Overactive Bladder Feel Like

What Are Botoxs Mild Side Effects

The mild side effects of Botox can vary depending on the condition its being used to treat. Some side effects also differ between adults and children using the drug.

Mild side effects reported in people using Botox for overactive bladder symptoms include:

Mild side effects reported in people using Botox for detrusor overactivity* linked with a neurological condition include:

  • UTI
  • urinary retention

Mild side effects reported in children using Botox for detrusor overactivity linked with a neurological condition include:

  • UTI
  • bacteria in the urine
  • leukocytes in the urine

In many cases, mild side effects from the drug can be temporary. Some side effects may be easy to manage, too. But if side effects last for a longer time, or if they bother you or become severe, talk with your doctor or pharmacist.

* This refers to overactivity of the detrusor muscle, which is the muscle that lines the bladder.

About Oab And Detrusor Overactivity

OAB and detrusor overactivity can both cause trouble with urination. With these conditions, you may have involuntary spasms in your bladder muscles, even when you dont actually need to urinate.

The exact cause of OAB isnt known. But some possible factors or causes may include:

  • consuming caffeine, alcohol, or other bladder irritants
  • taking medications that increase urine output
  • other bladder problems, such as bladder stones
  • not completely emptying the bladder

Detrusor overactivity can be linked with neurological conditions such as MS or a spinal cord injury. These neurological conditions affect how your brain communicates with the rest of your body. In some cases, they can cause bladder problems such as detrusor overactivity.

Recommended Reading: I Feel A Lot Of Pressure On My Bladder

How Does Botox Work

Botox helps relieve the symptoms of bladder problems by promoting bladder control.

The detrusor muscle that lines the bladder plays an important role in bladder control. When the muscle relaxes, the bladder can fill with urine. When youre urinating, the muscle contracts to release urine.

If you have overactive bladder symptoms or detrusor overactivity, your bladder muscles spasm involuntarily . Botox is injected into the detrusor muscle to block the nerve signals to the muscle. This helps control the muscles contractions.

Below are answers to some commonly asked questions about Botoxs use in treating bladder conditions.

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