Botox is a prescription medication used to treat certain bladder problems, such as overactive bladder in adults. It works by decreasing the force of the natural contraction of the bladder, which can help to eliminate bladder spasms. The effects of Botox are temporary and last between six and 12 weeks. The main potential risk of Botox is that it can worsen bladder emptying.
There are two side effects associated with injecting Botox into the bladder. The first is an increase in postural waste, that is, the amount of urine that remains in the bladder after urination. In most cases, this doesn't cause any symptoms and doesn't need treatment. However, in some patients (about 6% in clinical trials) it can be a problem and may require the temporary use of a catheter to help empty the bladder.
When this occurs, patients are taught to catheterize once or several times a day due to problems associated with increased post-vacuum residue, such as total inability to urinate (urinary retention). In the small number of people in whom this occurs, the need for catheterization usually lasts 2 to 6 weeks. Other side effects include bleeding in the urine or a urinary tract infection, which can occur with or without high post-vacuum residue. After receiving a Botox injection, your bladder control may have improved for about 12 weeks. Some people may continue to have bladder control after 24 weeks.
After this period, the Botox effect wears off and you'll need more injections. Botox works too well in some cases and patients can't urinate on their own, or they have some residual urine in their bladder that isn't eliminated with normal urination. A little residual urine doesn't cause much trouble, but if this residual urine is high or the patient cannot empty the bladder, a catheter must be placed or a catheter must be passed periodically to drain the bladder. This complication is rare in patients with overactive bladder, because we limit the amount of Botox we inject. Bladder Botox has been shown to produce dramatic improvements in symptoms and quality of life in women who did not respond to other treatments or could not tolerate them. Here are answers to some frequently asked questions about the use of Botox to treat bladder conditions. Botox has a prolonged effect on the bladder compared to other muscles, where it can only last for a few months.
To treat bladder conditions, Botox is given by injection into the detrusor muscle (the muscle that lines the bladder). Adults with detrusor hyperactivity will receive a higher dose of Botox, which is injected at 30 sites, located 1 cm apart in the detrusor muscle. Botox is used in children age 5 and older with detrusor hyperactivity caused by a neurological condition. Botox is packaged as a powder that a health professional mixes with liquid to prepare an injectable solution. If you use Botox to treat OAB symptoms, you'll need to show that you can urinate before leaving the doctor's office. Botox is injected into the detrusor muscle (the main muscle of the bladder) to block nerve signals that reach the muscle.
Your doctor will determine the dose of Botox based on your condition and your response to previous Botox treatments. For use in adults with detrusor hyperactivity caused by a neurological condition, the recommended dose is 200 units of Botox. At each injection appointment, adults with symptoms of OAB or children with detrusor hyperactivity will receive a Botox injection at 20 sites, located 1 centimeter (cm) away in the detrusor muscle. The minimum period between injections is 12 weeks, but in some cases, people feel the effects of Botox for longer periods.
