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How Do They Inject Botox Into The Bladder

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How Do They Put Botox In Your Bladder

What is Botox Bladder Injection like for Men?

Where do they inject Botox for bladder control? Botox is injected directly into the bladder muscle. Your doctor will guide a thin tube, called a cystoscope, up your urethra and into your bladder. Your doctor can see inside your bladder with the cystoscope and deliver the Botox injections through it.

What is the success rate of Botox in the bladder?

The success rate of Botox® bladder injections ranges from 60 to 90 percent for urgency urinary incontinence and the symptoms that go along with it, like urinary frequency and urinary urgency. About Botox Botox is a drug made from a toxin produced by bacteria, which is called botulinum toxin.

What To Expect After Botox Injection In Bladder

If youve ever gone for a jog and felt a trickle down below, or coughed and caught yourself leaking urine, you arent alone. The involuntary loss of urine is called urinary incontinence and more than 25 million Americans experience it Read More

If youve ever gone for a jog and felt a trickle down below, or coughed and caught yourself leaking urine, you arent alone. The involuntary loss of urine is called urinary incontinence and more than 25 million Americans experience it every day. Urinary incontinence can be caused by several factors from a urinary tract infection to overactive bladder to pregnancy and childbirth. The good news is urinary incontinence is a treatable medical condition, with one of the most effective treatments being Botox.

When most people think of Botox, they usually think of injections to the face to minimize wrinkles. However, Botox bladder injections are a routine treatment for urinary incontinence.

Here is a guide to what you should know about Botox injections in the bladder.

How To Inject Botox: For Medical Professionals

Prime the injection needle with 1ml of Botox to remove any air, before commencing with the injections. The solution is then injected into the detrusor muscle via a flexible or rigid cystoscope, avoiding the trigone in the process. Administration consists of either 20 injections of 0.5ml each, spaced 1cm apart and made to a depth of about 2mm into the detrusor or 30 injections of 1ml each, spaced 1cm apart and made to a depth of about 2mm into the detrusor . The final injection should include 1ml of sterile normal saline so that all remaining Botox in the needle is administered. Once treatment is complete, the patient must be able to void before they can be allowed to leave the clinic. A 30-minute post-treatment observation of the patient should be performed. The practitioner should keep the following points in mind when administering Botox to patients for bladder dysfunction: to take special care when performing the cystoscopy, to ensure that the patient has discontinued any anticoagulants they may be taking to minimize risk of bleeding, and to administer antibiotics before, during and after treatment to reduce the chances of a urinary tract infection .

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How Is The Botox Treatment For Overactive Bladder Performed

Botox Treatment for Overactive Bladder may be undertaken in the following manner:

  • The procedure is performed by applying a local anesthetic agent to the pelvic site. Occasionally, the individual may be administered general anesthesia
  • The inside of the urinary bladder is explored by the urologist by inserting a cystoscope, which is a thin tube having a tiny camera at its end
  • Botox injections are then administered to the targeted site , through the thin tube several injections may be given during a session
  • Following the procedure, the individual is placed under observation for a period of time, until they first pass urine. In some cases, hospitalization may be necessary and the patient may be asked to stay overnight

How Does Botox Work

Can Urinary Incontinence Cause UTIs? Short answer

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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Are There Any Other Important Points

Because Botox inhibits the action of bladder muscle, it is possible that the effect may be too much for your bladder, and that you may not be able to pass urine normally for as long as it takes the effect of Botox to wear off . This is rare, but if it occurred, you would need to perform intermittent self-catheterisation for this period of time. It is usual for you to be taught ISC before you have Botox to ensure that, in the rare event that you were affected in this way, you would be able pass a catheter yourself.

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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.

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Who Is Suitable For Botox

Patients with a diagnosis of overactive bladder who suffer from a strong urge to pass urine that does not respond to medication. Botox injections may produce good symptom relief.

Additionally, patients with neurological problems causing an overactive bladder and / or high pressure in the bladder. Neurological conditions that affect the bladder include:

  • Spinal Cord problems.
  • Multiple Sclerosis.
  • Parkinsons disease.

It is a well-tolerated procedure, but the effect is temporary, and injection may need to be repeated after approx. 9 months.

Men or women with the symptoms or problems mentioned above may be suitable for Botox injection into the bladder. Generally, patients should have gone through a series of other treatments such as bladder physiotherapy and / or bladder retraining, have tried oral medication for their symptoms, and have failed these treatments before Botox is considered.

What Happens During The Treatment

Botox for an Overactive Bladder — The Doctors

Dr. Nguyen first uses a numbing agent on the bladder before inserting a camera into your bladder. He then uses a camera to guide the needle placement and injects small amounts of Botox in a pattern of about 20 locations throughout the bladder. It is usually done in the office as a 30-minute procedure under local anesthesia, though if you would prefer full anesthesia, it can also be performed in an operating room.

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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 .

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What Are The Long

There is a small chance of side effects in the first 12 weeks following Botox injections in the bladder. The most common side effect following Botox injections in the bladder is urinary tract infection . Your doctor may prescribe an antibiotic before your procedure to prevent the chances of you developing UTI. Other side effects include difficult or painful urination and the inability to fully empty your bladder. If you experience any of these side effects, it is important to let your doctor know.

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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 Is Botox And How Does It Work


Botox is a purified form of Botulinum toxin type A, a very powerful muscle relaxant. It causes muscle relaxation by preventing the release of chemicals called neurotransmitters that normally are released from a nerve cell, travel across to a muscle cell, and signal it to contract. This action of the toxin lasts for a limited amount of time, eventually wearing off as the nerve cells regain their ability to release these molecules.

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How Often Can You Get Botox Injections In Bladder

Youll need to track the symptoms of your bladder condition so that your doctor can determine how often you need the injections. The minimum period between injections is 12 weeks, but in some cases, people feel the effects of Botox for longer periods. This means that they may need injections less often.

How often can you have Botox in the bladder?

Frequency of injections Botoxs effects last approximately 6 months and then needs to be re-injected when the patient notices the benefits are wearing off. Patients must wait at least three months between treatments, but there is no limit on the number of times this treatment can be used.

After The Botox Injection

BOTOX injections typically take only a few minutes, with the session lasting less than a standard lunch break.

Before you leave the clinic you will be advised to avoid lying down for around 4 hours and to refrain from any exercise or activity that is over strenuous for the rest of the day. Other aftercare advice includes not booking a facial or similar beauty treatment for at least 1 week.

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Who Is Eligible For Botox Treatments

A patient who is complaining of overactive bladder/urinary urge incontinence may be a candidate to receive this treatment. The good thing about Botox is that there is no age range of who is a best candidate and its not limited to one gender. However, this treatment is not used to treat stress urinary incontinence, which is a separate condition where an involuntary loss of urine that occurs during physical activity, such as coughing, sneezing, laughing, or exercise.

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Botox Should Not Be Used In Patients With

How Botox can be used to treat an overactive bladder
  • Myasthenia Gravis, Eaton Lambert Syndrome or Amyotropic Lateral Sclerosis
  • Known hypersensitivity to and ingredient in the formulation
  • In the presence of urine infection
  • In conjunction with aminoglycoside antibiotics e.g. gentamicin or other drugs that interfere with neuromuscular transmission.
  • During pregnancy or breast feeding.
  • Haemophilia or other bleeding disorders

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The Botox Treatment Procedure

Prior to the day of treatment, the patient will be given an antibiotic to reduce the chances of a urinary tract infection . Before treatment, a test will be completed to make sure the patient does not have a UTI. If they do have one, the treatment will be rescheduled.

At Urology Associates Botox is administered under general anesthesia or sedation in an ambulatory surgical center. The doctor performs a cystoscopy by inserting a cystoscope through the urethra, the opening where urine exits the body. Botox is given through the cystoscope by a series of quick injections into specific areas of the patients bladder muscle.It can take 24-72 hours before the Botox takes effect, but in rare cases it may take longer.

About 6 out of every 100 patients require a catheter after the treatment. If this is needed, the doctor will discuss the catheter process including cleaning prior to treatment. This is a smaller catheter than those found in hospitals and can be easily hidden.

Does Botox For Bladder Control Really Work

Do you have constant urges to urinate that you cannot control? Even if you drink a lot of water, you might have a bladder problem that makes you urinate frequently. The official term for this problem is overactive bladder or uncontrollable bladder.

Keep track of how many times you go to the bathroom on a given day. If it is more than eight times, then you likely have an overactive bladder problem. Its even worse if you leak urine before you reach the bathroom due to incontinence. Urination accidents are clear signs that you need to seek treatment from a qualified urologist immediately.

Overactive bladders dont discriminate against gender. Males and females are both susceptible to developing overactive bladder disorder. When the brain and bladder cannot communicate effectively, then a full bladder cannot signal to the brain that it needs relief. That is one reason for incontinence.

The signal between the brain and bladder gets messed up if the bladder muscles contract too much. All that contraction adds pressure and stress to the bladder sphincters. If you develop an uncontrollable desire to urinate frequently, it is probably due to the bladder sphincters getting too stressed.

A urologist wont typically recommend Botox as the first treatment option. They will recommend you try products and medications first. But if those other bladder control treatments have failed you, the urologist will recommend Botox as an alternative to surgery.

Lesson to Remember

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Are There Any Side Effects

Potential side effects from this treatment include:

There is risk of a urinary tract infection from any procedure on the bladder, including this one.

In less than 5% of procedures, urinary retention can occur. This happens when the bladder is so relaxed that it cant empty. These patients may not be able to fully empty their bladder. In these cases, patients are taught to periodically insert a small catheter to empty their bladder until their bladder function returns.

Does Botox Work With Oab

Botox for your bladder: How it works

While doctors do not recommend Botox in the bladder as the first line of treatment for OAB and other bladder problems, it is a viable, proven option if lifestyle changes and medications do not prove successful in providing relief from symptoms.

A medical professional will inject Botox directly into the muscle of the bladder wall to relax it. This can prevent the bladder muscles from squeezing too often or too intensely, which reduces urinary urgency and frequency.

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How Does Botox Work For Incontinence

The drug decreases the spasms that cause overactive bladder symptoms, Dr. Vasavada explains. Its not so much for frequency of urination, as much as that sudden urge to go. Its good to help people when its something they cant postpone without leakage occurring.

The outpatient or office-based procedure to deliver the drug involves using a little numbing medicine, followed by a 15-minute, short series of small injections into the wall of the bladder.

The drug, which typically takes about a week to begin to work, chemically affects muscle-nerve connections. Thats why Botox can also be used to treat other disorders, including chronic migraine and severe underarm sweating.

Why Choose The University Of Maryland Medical Center

The University of Maryland’s Center for Continence and Pelvic Health is a one stop-shop for patients with urinary incontinence. Our physicians have the training and expertise necessary to provide the most advanced care available for women with problems related to the lower urinary tract or pelvic floor. Our team of gynecologists and urologists work together to provide patients with the best evidence-based medicine to treat urinary incontinence.

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Risk With Botox Treatment

Sometimes Botox works too well, and the bladder has difficulty emptying. In rare occasions it may require a doctor to pass a catheter into the bladder in order to empty it and can last until the Botox wears off.

If you are experiencing symptoms for overactive bladder it you would be advised to see your general practitioner and possibly obtain a referral to see Dr Gailani at

Botox Is A Highly Effective Treatment For Urinary Incontinence

Botox Injections for Neurogenic Bladder

Youve likely seen those ubiquitous TV commercials for drugs that treat overactive bladder. Perhaps youre even one of more than an estimated 25 million American adults who have the condition.

Weve all had that experience of putting the key in the door and making a run for the bathroom knowing we shouldve gone half an hour ago, said Dr. John J. Jack Smith, III, a urologist with in Winston-Salem. But patients with overactive bladder dont really have any warning thats coming on. The urge happens that fast.

Smith said the ads and catchy jingles may help destigmatize this very common problem one that impacts twice as many women as men. But pharmaceutical therapies arent the only tool in his arsenal.

Physicians have been using Botox off label and with excellent results for many years to treat urinary incontinence. Smith has been using it for more than two decades. The FDA approved it for use with overactive bladder, a condition that refers to both urgency and frequency, in 2013.

The drug works by reducing the muscle contractions that cause leaks and urgency.

Its highly effective it works for well over 80% of those who try it, Smith said but it isnt the first treatment a doctor will try. Its a tertiary treatment, which Smith explained is the third treatment insurance companies will allow physicians to try if the first two fail to get results. The proper order:

Find the right specialist for you.

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